Beyond pain control: Outcome and treatment preferences in pediatric migraine.
Beyond pain control: Outcome and treatment preferences in pediatric migraine.
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DOI：
10.1111/head.14315
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发表时间：
2022-05
期刊：
影响因子：
5
通讯作者：
Lemmon, Monica E.
中科院分区：
文献类型：
--
作者：
Khayata, Matthew J.;Farley, Samantha;Davis, J. Kelly;Hornik, Christoph P.;Reeve, Bryce B.;Rikhi, Aruna;Gelfand, Amy A.;Szperka, Christina L.;Kessel, Shirley;Pezzuto, Tara;Hammett, Alex;Lemmon, Monica E.
描述儿童和青少年偏头痛患者及其照顾者的治疗偏好和现有结果测量的感知质量。在各个学科中，越来越多的人认识到利益相关者直接投入的价值。很少有实证研究来确定哪些结果对患有偏头痛的儿科患者及其护理人员最重要。在这项定性研究中，我们从多中心前瞻性儿科偏头痛登记处招募了参与者。我们采用分层有目的抽样方法招募不同年龄和头痛频率的儿童和青少年。偏头痛患者及其护理人员完成了针对治疗偏好和现有结果测量的感知质量的半结构化访谈。使用传统的内容分析确定了新兴主题和次级主题。本研究共纳入30对儿童/青少年及其照顾者，共完成59次访谈（n=29名儿童/青少年访谈，n=30名照顾者访谈）。出现了三个主题。1)症状缓解：超越头痛解决：参与者描述了除了疼痛缓解之外的结果价值，包括偏头痛强度的降低和非疼痛症状的改善。2)副作用和缓解之间的权衡：参与者描述了头痛治疗可能发生的成本效益分析，并承认药物副作用对日常生活和药物依从性的影响。3)以儿童为中心的治疗：参与者描述了儿童环境中突出的药物属性，包括适合年龄的给药途径和充分的安全性数据。除了传统研究的偏头痛终点外，儿童、青少年和照顾者受偏头痛影响的价值结果。参与者重视疼痛严重程度的降低，即使在没有疼痛缓解的情况下。参与者还优先考虑无副作用和关键药物属性，包括快速起效和适合年龄的给药途径。这些结果强调了设计以患者为中心的临床试验、开发药物和支持产品标签的机会，这些标签与偏头痛儿童和青少年及其护理人员最重视的结果一致。
To describe treatment preferences and perceived quality of existing outcome measures among children and adolescents with migraine and their caregivers. Across disciplines, there is increasing recognition of the value of direct input from stakeholders. Little empirical work has been done to determine what outcomes matter most to pediatric patients with migraine and their caregivers. In this qualitative study, we recruited participants from the multicenter, prospective Pediatric Migraine Registry. We used stratified purposive sampling to recruit children and adolescents of varied age and headache frequency. Patients with migraine and their caregivers completed semi-structured interviews targeting treatment preferences and perceived quality of existing outcome measures. Emergent themes and subthemes were identified using conventional content analysis. Thirty dyads of children/adolescents and their caregivers were enrolled and completed 59 interviews (n=29 children/adolescent interviews, n=30 caregiver interviews). Three themes emerged. 1) Symptom relief: Looking beyond headache resolution: Participants described the value in outcomes in addition to pain relief, including a reduction in migraine intensity and improvement in non-pain symptoms. 2) Trade-offs between side effects and relief: Participants described cost-benefit analyses that can occur with headache treatment and acknowledged the impact of drug side effects on daily life and medication adherence. 3) Child-centered treatment: Participants described medication attributes salient to the pediatric context, including age-appropriate routes of administration and adequate safety data. Children, adolescents, and caregivers impacted by migraine value outcomes in addition to traditionally studied migraine endpoints. Participants valued decreased pain severity, even in the absence of pain resolution. Participants also prioritized the absence of side effects and key medication attributes, including fast onset and age-appropriate routes of administration. These results highlight an opportunity to design patient-centered clinical trials, develop drugs, and support product labeling that align with the outcomes valued most by children and adolescents with migraine and their caregivers.
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影响因子：
5
作者：
Lipton RB;Dodick DW;Ailani J;McGill L;Hirman J;Cady R
通讯作者：
Cady R
影响因子：
5
作者：
Houts CR;McGinley JS;Nishida TK;Buse DC;Wirth RJ;Dodick DW;Goadsby PJ;Lipton RB
通讯作者：
Lipton RB
影响因子：
2.6
作者：
Trigo-López J;Guerrero-Peral ÁL;Sierra Á;Martínez-Pías E;Gutiérrez-Sánchez M;Huzzey E;García-Azorín D
通讯作者：
García-Azorín D
影响因子：
4.9
作者：
Abu-Arafeh, Ishaq;Hershey, Andrew D.;Tassorelli, Cristina
通讯作者：
Tassorelli, Cristina
影响因子：
4.9
作者：
Diener, Hans-Christoph;Tassorelli, Cristina;Mandrekar, Jay
通讯作者：
Mandrekar, Jay