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Examining the Utility of In-Clinic "Rescue" Therapy
for Acute Migraine
Veronica Morey, RN; John F. Rothrock, MD
Posted: July 2008  
Headache   2008;48:939-943

Background:   Management options currently are limited for patients with acute migraine whose symptoms prove refractory to self-administered therapy.

Objective:   To evaluate the clinical utility and cost-effectiveness of a management program offering in-clinic "rescue" treatment for patients with acute migraine.

Methods:   Two hundred consecutive migraine patients presenting to a university-based headache clinic were randomized to receive either optimal self-administered medical therapy for acute migraine ("standard therapy") or similar therapy plus the option of in-clinic parenteral drug administration should self-administered therapy prove ineffective ("rescue therapy"). Patients randomized to the latter group were restricted to a maximum of 2 "rescue visits" per month, and all patients were followed for one year. Patients "rescued" in clinic were contacted by telephone 24 hours following treatment to evaluate their treatment response.

Conclusion:   Providing the alternative of in-clinic "rescue" for acute migraine refractory to self-administered therapy offers an attractive alternative for patients and appears to substantially lower use of an emergency department for headache treatment and the cost associated with that use.