Prevalence, pattern and predictors of use of complementary and alternative medicine (CAM) in migraine patients attending a headache clinic in Italy
Prevalence, pattern and predictors of use of complementary and alternative medicine (CAM) in migraine patients attending a headache clinic in Italy
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DOI：
10.1111/j.1468-2982.2005.00898.x
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发表时间：
2005-07-01
期刊：
影响因子：
4.9
通讯作者：
Nappi, G
中科院分区：
文献类型：
--
作者：
Rossi, P;Di Lorenzo, G;Nappi, G
在偏头痛中使用补充和替代医学(CAM)是一种日益增长的现象，人们对此知之甚少。这项研究是为了评估不同亚型偏头痛患者临床人群中使用CAM的比率、模式和预测因素的存在。481名在头痛诊所就诊的偏头痛患者被要求接受一项由医生管理的结构化访谈，旨在收集有关CAM使用的信息。在接受调查的患者中，31.4%的患者报告过去使用过CAM疗法，其中17.1%的患者在前一年使用过CAM。39.5%的患者认为CAM疗法是有益的。与发作性偏头痛患者相比，转化偏头痛患者报告CAM治疗无效的比例明显更高(73.1%对50.7%，P<；0.001)。CAM最常见的推荐来源是朋友或亲戚(52.7%)。在大多数情况下，偏头痛患者求助于CAM治疗是专门针对他们的头痛(89.3%)。大约61%的CAM用户没有通知他们的医生他们的CAM使用情况。决定尝试CAM疗法的最常见原因是它能“潜在地改善头痛”(47.7%)。CAM治疗的最大使用者是：被诊断为转化性偏头痛的患者；咨询过大量专家并报告一生中常规就诊次数较多的人；患有共病精神障碍的人；高收入者；以及那些被误诊或根本没有被诊断为头痛的人。我们的研究结果表明，头痛诊所偏头痛患者在他们需要和寻求护理的过程中，寻求和探索传统和CAM方法。医生应该意识到这种由患者驱动的医疗环境变化，以防止滥用医疗资源，并更好地准备满足患者的需求。
The use of complementary and alternative medicine (CAM) in migraine is a growing phenomenon about which little is known. This study was undertaken to evaluate the rates, pattern and presence of predictors of CAM use in a clinical population of patients with different migraine subtypes. Four hundred and eighty-one migraineurs attending a headache clinic were asked to undergo a physician-administered structured interview designed to gather information on CAM use. Past use of CAM therapies was reported by 31.4% of the patients surveyed, with 17.1% having used CAM in the previous year. CAM therapies were perceived as beneficial by 39.5% of the patients who had used them. A significantly higher proportion of transformed migraine patients reported CAM treatments as ineffective compared with patients suffering from episodic migraine (73.1% vs. 50.7%, P < 0.001). The most common source of a recommendation of CAM was a friend or relative (52.7%). In most cases, migraineurs' recourse to CAM treatments was specifically for their headache (89.3%). Approximately 61% of CAM users had not informed their medical doctors of their CAM use. The most common reason for deciding to try a CAM therapy was that it offered a 'potential improvement of headache' (47.7%). The greatest users of CAM treatments were: patients with a diagnosis of transformed migraine; those who had consulted a high number of specialists and reported a higher lifetime number of conventional medical visits; those with a comorbid psychiatric disorder; those with a high income; and those whose headache had been either misdiagnosed or not diagnosed at all. Our findings suggest that headache clinic migraine patients, in their need of and quest for care, seek and explore both conventional and CAM approaches. Physicians should be made aware of this patient-driven change in the medical climate in order to prevent misuse of healthcare resources and to be better equipped to meet patients' needs.