Prescribing for acute migraine in a rural Australian hospital

Prescribing for acute migraine in Australia is highly variable by context. This single-site study has similarities and differences with prior research. Rates of opioid prescribing were lower, possibly due to the known sparing effect of serotonin receptor agonist usage. Similar rates of NSAID and intravenous hydration prescription occurred. Patterns of intervention over time in this rural ED demonstrated strong adherence to guidelines and low opioid utilisation. Contextual differences proposed to impact prescribing include staff training, medication availability and shorter wait times. Imaging and pathology investigation rates were lower than in prior research and did not change disposition. Future studies across multiple rural hospitals may help understanding of this topic.