Patterns of diagnosis and acute and preventive treatment for migraine in the United States: Results from the American Migraine Prevalence and Prevention study
Patterns of diagnosis and acute and preventive treatment for migraine in the United States: Results from the American Migraine Prevalence and Prevention study
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DOI：
10.1111/j.1526-4610.2006.00631.x
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发表时间：
2007-03-01
期刊：
影响因子：
5
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
--
作者：
Diamond, Seymour;Bigal, Marcelo E.;Lipton, Richard B.
客观。-描述美国偏头痛患者的医疗模式。背景。在过去的十年中，许多新的治疗偏头痛的方法已经成为可用的，偏头痛的意识已经提高。然而，在美国社会的医疗模式的信息很少。设计/方法。-一份经过验证的自我管理头痛问卷被邮寄给随机抽样的120，000个美国家庭。每个患有严重头痛的家庭成员都被要求完成调查。问卷调查评估头痛的特点，残疾和医疗模式。受试者根据他们使用头痛预防药物进行分类，如当前用户，重合用户（使用其他医疗原因的有效药物），失效用户（过去使用过，但在调查时没有），或从未使用过。在162，576名参与者中，偏头痛的患病率在女性中为17.1%，男性为5.6%。只有56.2%的偏头痛患者接受过医学诊断。98%的偏头痛患者使用急性治疗来治疗偏头痛发作。49%的人通常使用非处方药，20%的人通常使用处方药，29%的人两者都使用。只有12.4%的偏头痛患者表示他们正在服用偏头痛预防药物，但17.2%的人因其他医学原因而使用具有潜在抗偏头痛作用的药物。目前或既往使用预防性药物的女性比男性更有可能（比值比[OR] = 1.37，95%置信区间[CI] 1.27-1.48），随着年龄和MIDAS分级较高的个体而增加（IV级vs I级，OR 2.35，95% CI 2.09-2.64）。预防性药物的使用随着对偏头痛的认识和疾病的严重程度而增加。偏头痛在美国人口中仍然治疗不足。预防性治疗的障碍在年轻群体、男性和不知道自己患有偏头痛的人中更大。
Objective.-To describe the patterns of medical treatment for migraineurs in the United States.Background.-Over the past decade, many new treatments for migraine have become available and awareness of migraine has improved. However, there is little information about the patterns of medical treatment in the US society.Design/Methods.-A validated self-administered headache questionnaire was mailed to a random sample of 120,000 US households. Each household member with severe headaches was asked to complete the survey. The questionnaire assessed headache features, disability, and patterns of medical treatment. Subjects were classified according to their use of headache preventive medication, as current users, coincident users (using effective medications for other medical reasons), lapsed users (had used in the past but not at the time of the survey), or never users.Results.-In 162,576 participants, the prevalence of migraine was 17.1% in women and 5.6% in men. Only 56.2% of those with migraine had ever received a medical diagnosis. Ninety-eight percent of the migraineurs used acute treatment for their migraine attacks. Forty-nine percent (49%) usually used over-the-counters, 20% usually used prescription medications, and 29% used both. Only 12.4% of migraineurs indicated that they were taking a migraine preventive medication, but 17.2% were using medications with potential antimigraine effects for other medical reasons. Current or past use of preventive medication was more likely in women than men (odds ratio [OR] = 1.37, 95% confidence interval [CI] 1.27-1.48), increased with age and individuals with high MIDAS grade (Grade IV vs I, OR 2.35, 95% CI 2.09-2.64). Preventive medication use increased with awareness of migraine and with illness severity.Conclusions.-Migraine remains undertreated in the US population. Barriers to preventive treatment are greater in younger age groups, men, and people unaware that they have migraine.