Week 4 Discussion, Main Post Chronic migraines

 Week 4 Discussion, Main Post Chronic migraines, defined as fifteen or more headache days per month, affect approximately 1% of the population (American Migraine Foundation, 2016). There have been several different medications over the years to help prevent or alleviate migraine headaches. Anti-seizure, anti-depressant, and high blood pressure medications are all commonly prescribed to help prevent chronic migraines. None of these drugs have gained the United States Food & Drug Administration approval for this treatment. Botulinum toxin injections became the first United States Food & Drug Administration approved treatment to prevent chronic migraines in 2010 (American Migraine Foundation, 2016). My clinical area of interest is to inquire how effective this medication is. My PICOT question is: In adult patients diagnosed with chronic migraines, do botulinum toxin injections, compared to placebo or no preventive medication interventions, reduce the frequency of migraine days per month for the three-month duration of treatment? While researching my PICOT question, I initially searched Cinahl Plus with Full Text. I started with Cinahl Plus entering in the filters, 2015-2020, peer-reviewed, full text, adults, and English language. I entered the keywords botulinum toxin, migraine, and prevention with the Boolean operator AND between each key term (Stillwell et al., 2010). This search brought up 16 articles. I eliminated most of these articles because they included information on treatments other than botulinum toxin. Several of these articles were prospective cohort studies that may be useful. I know that systematic reviews and meta-analyses are the highest levels of evidence, so I continued my search (Stillwell et al., 2010). The next database I searched was Pub Med. I selected the same filters as I did for Cinahl Plus. On Pub Med, I was also able to choose systematic reviews and meta-analyses. Pub Med initially gave me two resources. Both items are meta-analysis/systematic reviews