Prophylactic treatment of migraine by GPs: a qualitative study
Prophylactic treatment of migraine by GPs: a qualitative study
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DOI：
10.3399/bjgp12x636100
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发表时间：
2012-04-01
影响因子：
5.9
通讯作者：
Assendelft, Willem J. J.
中科院分区：
文献类型：
--
作者：
Dekker, Frans;Neven, Arie Knuistingh;Assendelft, Willem J. J.
背景：尽管偏头痛有相当大的影响，但预防性药物在初级保健中的使用是有限的。目的：探讨全科医生对偏头痛预防用药的看法。设计与地点：采用荷兰全科医学的定性焦点小组研究。方法：建立4个焦点小组，每组6名。有目的地对全科医生进行抽样，以获得一系列的参与者，以反映更普遍的全科医生人群。结果：全科医生了解到患者对偏头痛的影响和预防措施的潜在好处的担忧。然而，由于对有效性、潜在副作用和形成药物依赖的风险的怀疑，一些人对开始开预防药犹豫不决。全科医生的决定通常是基于国家指南之外的考虑因素，例如，患者需要控制自己的问题。许多全科医生将发起预防的责任放在患者身上。结论：各种考虑因素阻碍了全科医生使用预防性药物管理偏头痛，而各种与患者相关的担忧导致全科医生偏离国家头痛指南。
Background:Despite the considerable impact of migraine, the use of preventive medication in primary care is limited. Only about 5% of migraine patients who qualify for prophylaxis actually receive it, and adherence is far from optimal.Aim:To explore the opinions of GPs regarding preventive medication for migraine.Design and setting:A qualitative focus group study in Dutch general practice.Method:Four focus groups (six GPs each) were formed. GPs were purposively sampled to acquire a range of participants, reflecting the more general GP population.Results:GPs perceived patients' concerns about the impact of migraine and the potential benefits of prophylaxis. However, some were hesitant to start prescribing prophylaxis due to doubts about effectiveness, potential side effects, and the risk of developing drug dependency. GPs' decisions were often based on considerations other than those presented in national guidelines, for example, the patient's need to control their own problem. Many GPs placed responsibility for initiating prophylaxis with the patient.Conclusion:Various considerations hamper GPs from managing migraine with preventive medication, and various patient-related concerns cause GPs to deviate from national headache guidelines.