Management of primary chronic headache in the general population: the Akershus study of chronic headache.
Management of primary chronic headache in the general population: the Akershus study of chronic headache.
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DOI：
10.1007/s10194-011-0391-8
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发表时间：
2012-03
影响因子：
7.4
通讯作者：
Russell, Michael Bjorn
中科院分区：
文献类型：
--
作者：
Kristoffersen, Espen Saxhaug;Grande, Ragnhild Berling;Aaseth, Kjersti;Lundqvist, Christofer;Russell, Michael Bjorn
关键词：
原发慢性头痛导致更多的残疾，并需要高度利用卫生保健。我们的知识基于选定的人群，而来自普通人群的信息在很大程度上是缺乏的。一项按年龄和性别分层的横断面流行病学调查包括30,000名年龄在30-44岁的人。自称患有慢性头痛的受访者接受了医生的采访。研究采用了国际头痛疾病分类法。在所有主要的慢性头痛患者中，80%曾咨询过他们的全科医生，其中19%还咨询过神经科医生，4%曾住院治疗。偏头痛的并存增加了与医生接触的可能性。严重程度的依赖量表得分越高，接触医生的可能性就越大。62%的人使用补充和替代医学(CAM)，最常见的是理疗、针灸和脊椎按摩。与医生的接触增加了使用CAM的概率。87%的人服用了急性头痛药物，而只有3%的人使用了预防性药物。大多数患有慢性头痛的人都由全科医生管理，五分之一的人从来不看医生，而大约五分之一的人被转介给神经科医生或住院治疗。急性头痛药物经常过度使用，而预防性药物很少使用。因此，避免急性头痛药物的过度使用和增加预防性药物的使用可能会改善未来对原发慢性头痛的管理。
Primary chronic headaches cause more disability and necessitate high utilisation of health care. Our knowledge is based on selected populations, while information from the general population is largely lacking. An age and gender-stratified cross-sectional epidemiological survey included 30,000 persons aged 30–44 years. Respondents with self-reported chronic headache were interviewed by physicians. The International Classification of Headache Disorders was used. Of all primary chronic headache sufferers, 80% had consulted their general practitioner (GP), of these 19% had also consulted a neurologist and 4% had been hospitalised. Co-occurrence of migraine increased the probability of contact with a physician. A high Severity of Dependence Scale score increased the probability for contact with a physician. Complementary and alternative medicine (CAM) was used by 62%, most often physiotherapy, acupuncture and chiropractic. Contact with a physician increased the probability of use of CAM. Acute headache medications were taken by 87%, while only 3% used prophylactic medication. GPs manage the majority of those with primary chronic headache, 1/5 never consults a physician for their headache, while approximately 1/5 is referred to a neurologist or hospitalised. Acute headache medication was frequently overused, while prophylactic medication was rarely used. Thus, avoidance of acute headache medication overuse and increased use of prophylactic medication may improve the management of primary chronic headaches in the future.
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