早期和轻度治疗:确诊偏头痛患者服用药物的时机

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Introduction.- Although research suggests that early treatment of migraine h eadache when the pain is mild results in better outcomes for patients, many pati ents delay taking their acute- migraine medication until their headaches are mo derate or severe. Understanding when and why patients use their migraine medicat ions is an important first step to improve migraine management. Methods.- A pro spective observational study, conducted at a major national retail pharmacy chai n with stores across the United States between April 2001 and November 2002, enr olled men and women between 18 and 55 years of age with a physician diagnosis of migraine with or without aura. Baseline data on 690 pa tients included patient demographics, migraine history, medication use, tendency to avoid or delay treatment of a migraine attack, and reasons for delaying trea tment. Reasons for delaying treatment were assessed via a checklist of nine pote ntial reasons. In the follow- up survey completed after treatment of the next m igraine attack, patients reported the timing of medication use in relation to pa in onset and the severity of the migraine headache at the time they took the med ication. Results.- Despite the severity of their typical migraine attacks, appr oximately 49% of the respondents answered, “ yes” to the question, “ Do yo u often avoid or delay taking your migraine medications when you start to experi ence a migraine attack?” The two most common rationales for avoiding or delayi ng treatment were “ wanting to wait and see if it is really a migraine attack” (69% ) followed by “ only want to take medications if it is a severe attack ” (46% ). In the follow- up survey, regardless of medication used, about 85 % of patients did not treat their next migraine attack until the headache pain was moderate or severe, although 74% treated within 1 hour of pain onset. Con clusion.- These results suggest that patients with migraine often delay their t reatment until they have identified their attack as a migraine. In addition, whi le many patients treated their follow- up headache early, they did not treat wh en the pain was mild. This suggests that there is an opportunity for physicians to educate their migraine patients on how to differentiate migraine from other h eadache types and about when and how to use their acute- migraine medication. Introduction .- Although research suggests that early treatment of migraine h eadache when the pain is mild results in better outcomes for patients, many pati ents delay taking their acute-migraine medication until their headaches are mo derate or severe. Understanding when and why patients use their migraine medicat ions is an important first step to improve migraine management. Methods.- A pro spective observational study, conducted at a major national retail pharmacy chai n with stores across the United States between April 2001 and November 2002, en olled men and women between 18 and 55 years of age with a physician diagnosis of migraine with or without aura. Baseline data on 690 pa tients included patient demographics, migraine history, medication use, tendency to avoid or delay treatment of a migraine attack, and reasons for delaying trea Reasons for delaying treatment were assessed via a checklist of nine pote ntial reasons. In the follow-up survey completed after treat ment of the next m igraine attack, patients reported the timing of the medication use in relation to pa in onset and the severity of the migraine headache at the time they took the medication. Results- Despite the severity of their typical migraine attacks, appr oximately 49% of the respondents answered, “yes” to the question, “Do yo u often avoid or delay taking your migraine medications when you start to experi ence a migraine attack?” The two most common rationales for avoiding or delayi ng treatment were “Wanting to wait and see if it is really a migraine attack” (69%) followed by “only want to take medications if it is a severe attack” (46%). In the follow-up survey, regardless of of medication used, about 85% of patients did not treat their next migraine attack until the headache pain was moderate or severe, although 74% treated within 1 hour of pain onset. Con clusion .- These results suggest that patients with migraine often delay their t reatment untilhave identified其使 that there is an opportunity for physicians to educate their migraine patients on how to differentiate migraine from other h eadache types and about when and how to use their acute-migraine
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