Polypharmacy Among Headache Patients: A Cross-Sectional Study
Polypharmacy Among Headache Patients: A Cross-Sectional Study
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DOI：
10.1007/s40263-018-0522-8
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发表时间：
2018-06-01
期刊：
影响因子：
6
通讯作者：
Rustichelli, Cecilia
中科院分区：
文献类型：
--
作者：
Ferrari, Anna;Baraldi, Carlo;Rustichelli, Cecilia
多种药物可以适当地治疗多种慢性疾病，但也会增加潜在的危害。尽管药物是治疗头痛的主要工具，但原发性头痛的多药治疗信息很少。目的是评估原发性头痛患者多药治疗的患病率、特征和危险因素，并检查这些变量在发作性头痛患者和慢性头痛患者之间是否存在差异。我们分析了多药治疗（同时使用五种或五种以上药物）、药物类型、合并症和风险因素（平均年龄42.81 ± 13.21岁）原发性头痛，分为发作性和慢性，传入头痛中心。患者平均服用4.37种药物。40.7%的患者多药使用，在慢性病患者中，多药使用率达到58.8%。大多数患者使用药物（主要是非甾体抗炎药; 73.5%）治疗急性头痛，30.4%的发作性和64.7%的慢性患者接受预防性治疗（P < 0.0001），主要使用抗抑郁药（77.3%）。高达76.7%的队列正在服用其他药物，主要用于酸相关疾病（21.7%）。59.7%的队列存在合并症。与多种药物治疗显著相关的变量是合并症、预防性治疗和曲坦类药物（P < 0.001）。原发性头痛患者，主要是年轻人，暴露于高剂量的多种药物治疗，与老年人相当。由于药物数量的增加会增加不良反应的风险，因此应经常检查原发性头痛患者同时服用的许多药物。
Polypharmacy can appropriately treat multiple chronic conditions, but it can also increase potential harm. Polypharmacy information for primary headaches is minimal, despite drugs being the main tools to manage headaches.The aim was to evaluate the prevalence, characteristics and risk factors of polypharmacy in patients with primary headaches and examine whether these variables differ between episodic and chronic headache patients.We analysed polypharmacy (simultaneous use of five or more medications), medication type, comorbidity, and risk factors in 300 patients (mean age 42.81 +/- 13.21 years) with primary headaches, divided into episodic and chronic, afferent to a headache centre.Patients took an average of 4.37 medications. Polypharmacy was common in 40.7% of patients, and among chronic patients, it reached 58.8%. Most patients used medications (mainly nonsteroidal anti-inflammatory drugs; 73.5%) to treat acute headaches, and 30.4% of episodic and 64.7% of chronic sufferers underwent prophylactic treatment (P < 0.0001), mostly using antidepressants (77.3%). Up to 76.7% of the cohort was taking other medications, primarily for acid-related disorders (21.7%). Comorbidities were present in 59.7% of the cohort. Variables significantly associated with polypharmacy were comorbidities, prophylactic treatment, and triptans (P < 0.001).Patients with primary headaches, mainly young adults, are exposed to high polypharmacy, comparable to that of the elderly. Because increased numbers of drugs increase the risk of adverse reactions, the many medications concomitantly taken by primary headache sufferers should be frequently reviewed.