scholarly journals Patients and general practitioners assessment of the main outcomes employed in the acute and preventive treatment of migraine: a cross sectional study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Javier Trigo-López ◽  
Ángel Luis Guerrero-Peral ◽  
Álvaro Sierra ◽  
Enrique Martínez-Pías ◽  
María Gutiérrez-Sánchez ◽  
...  
Keyword(s):  
General Practitioners ◽  
Preventive Treatment ◽  
Symptomatic Treatment ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Important Variable ◽  
Migraine Treatment ◽  
Cross Sectional ◽  
Sustained Effect ◽  
Action Time

Abstract Background We aim to describe and compare patients and general practitioners’ opinions about the different variables related to acute and preventive treatment for migraine. Patients and methods An observational descriptive study was performed. Patients with episodic migraine and general practitioners, from our healthcare area, were invited to answer a survey about the different variables related to migraine treatment. They were asked for their opinions on the different variables, and to consider the desired efficacy in percentage terms and the desired action times of treatment. Results Fifty-five patients and fifty-five general practitioners were selected. Effectiveness was considered the most important variable for symptomatic and preventive treatment. Cost was considered the least important variable. Patients desired percentage of efficacy was 84.0% (±16.7%) for symptomatic treatment and 79.9% (±17.1%) for preventive treatment. General practitioners desired percentage of efficacy was 75.0% (±14.0) for symptomatic treatment and 70.4% (±14.3) for preventive treatment. For symptomatic treatment the desired action time for pain cessation was selected as 27.5 min (±13.8) for patients and 24.0 min (±18.3) for GPs. For preventive treatment the desired action time for effect was 7.1 days (±4.5) for patients and 13.9 days (±8.9) for general practitioners. Conclusion The most important endpoints were, for acute: effectiveness, a short action time and a persistent effect. For prophylactic: effectiveness, sustained effect and tolerability. Both patients and general practitioners agreed on the most and least preferred endpoints. Desired percentage of efficacy was above 75% for both symptomatic and preventive treatment; and the desired action time was below 30 min for acute treatment and 2 weeks for preventive treatment.

scholarly journals Cognitive impairment in chronic migraine: a cross-sectional study in a clinic-based sample

2020 ◽  
Vol 78 (3) ◽  
pp. 133-138 ◽  
Author(s):  
Nina LATYSHEVA ◽  
Elena FILATOVA ◽  
Diana OSIPOVA ◽  
Alexey B. DANILOV
Keyword(s):  
Cognitive Impairment ◽  
Chronic Migraine ◽  
Verbal Learning ◽  
Depression Scale ◽  
Low Frequency ◽  
Preventive Treatment ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional

Abstract Cognitive impairment has been described in all phases of a migraine attack and interictally. However, the prevalence and phenotype of such impairment in chronic migraine (CM) have not yet been studied. Objectives: The aim of this study was to evaluate both the prevalence of the objective cognitive deficit in patients with CM and the factors underlying its etiology. Methods: 144 patients with CM and 44 age-matched patients with low-frequency episodic migraine (EM) (a maximum of 4 headache days per month) participated in this study. Neuropsychiatric characteristics were measured with the HADS Hospital Anxiety and Depression Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20). Results: Compared to EM, CM subjects demonstrated higher subjective and objective cognitive impairment across all tests. CM patients had 4 times higher odds of achieving a RAVLT score in the lower quartile range compared to EM (Odds Ratio [OR] 3.8; 95% confidence interval [95%CI] 1.5‒9.6; р=0.005). In the MoCA, CM patients demonstrated the most striking impairment in memory/delayed recall (65.3%), attention (46.5%), abstraction (30.6%), and language (27.1%). Chronic headache and level of education, but not gender, depression or anxiety, were independent predictors of cognitive impairment. Conclusions: Cognitive impairment is prevalent in the CM population during their mildest possible pain and may be caused by a central sensitization. Timely preventive treatment of EM is warranted.

scholarly journals Knowledge, Attitudes, and Management of General Practitioners of the Hospital Districts of Ouagadougou about Migraine (Burkina Faso)

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
A. A. Dabilgou ◽  
A. Dravé ◽  
J. M. A. Kyelem ◽  
A. Zoma ◽  
C. Napon ◽  
...  
Keyword(s):  
General Practitioners ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Moderate Intensity ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Ihs Criteria ◽  
Level Of Knowledge ◽  
The City

Background. Migraine is a common neurological disorder characterized by severe headache attacks that may be debilitating. The objective of this study is to determine the knowledge and attitudes of general practitioners in the hospital districts of the city of Ouagadougou on migraine. Methods. This cross-sectional study was carried out in hospital districts of Ouagadougou. The data were collected during three months from February 1 to April 30, 2020. Results. The study included 116 general practitioners. Thirteen percent of them were suffering from migraine. All participants had previous experience with migraine diagnosis before the survey. Eighty percent of general practitioners had a good level of knowledge of ICDH-3 criteria (knowing 6-7 criteria). The most widely recognized IHS criteria were pulsatility quality (93.1%), photophobia or sonophobia (80.2%), and mild-to-moderate intensity (80%). Ninety-five (81.9%) general practitioners rarely ordered brain imaging. The most common acute treatments were nonsteroidal inflammatory drug (39.47%), paracetamol (44.74%), and derivate of ergot (3.95%). The most common preventive treatments were amitriptyline (27.8%), derivate of ergot (18.9%), and NSAID (16.7%). The majority of general practitioners (56.9%) have referred headache patients to a colleague or specialist. Conclusions. Our study found that diagnostic criteria and acute treatment of migraine were well known by the majority of general practitioners, in contrast of preventive treatment.

scholarly journals Opioids and Migraine: Opioid Awareness and Frequency of Use among Turkish Migraineurs

2019 ◽  
Vol 7 (3) ◽  
pp. 139-145
Author(s):  
D. H. Ertem ◽  
C. I. Basarir ◽  
G. Baran ◽  
N. Gonderten ◽  
F. Ilik
Keyword(s):  
Chronic Migraine ◽  
Episodic Migraine ◽  
Opioid Therapy ◽  
Cross Sectional Study ◽  
Migraine Treatment ◽  
Opioid Use ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Cardiovascular Comorbidities ◽  
Frequency Of Use

Despite the inadequate evidence of effi cacy and safety of opioid use for the treatment of migraine, it has been reported that patients with moderate to severe migraine headaches are prescribed opioids. Migraineurs may experience serious health impacts from opioids such as headache-related disability, psychiatric and cardiovascular comorbidities. The reduction of the risk of opioid abuse and prevention of an opioid epidemic are important public health challenges. The aim of this study was to assess the awareness of opioid therapy for migraine and the frequency of use among Turkish patients with episodic and chronic migraine. Materials and methods: consecutive migraine patients were enrolled in this cross-sectional study. A semi-structured questionnaire was developed and used by the researchers to assess the patients’ awareness of an opiod treatment option and the frequency of use of opioids for migraine treatment. Results. One hundred two patients were enrolled, of which 72 had episodic migraine and 30 had chronic migraine. All subjects reported that they had not been offered or prescribed any kind of opioids by general practitioners and neurologists for their headache. Besides, only 7 % of patients declared that they had heard of opioid treatment for migraine but they had never consulted their doctors about its effects. Conclusions. Our fi ndings demonstrated that opioids were not preferred as an option for acute or preventive migraine treatment by Turkish migraineurs and their physicians. The reduction of opioid prescription will help to prevent the development of medication overuse and opiate-induced headaches and drug addiction.

scholarly journals Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal

2021 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Rita Baptista ◽  
Ryane Englar ◽  
Berta São Braz ◽  
Rodolfo Oliveira Leal
Keyword(s):  
General Practitioners ◽  
Healthcare Providers ◽  
Small Animal ◽  
Cross Sectional Study ◽  
Online Forums ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Current Trends ◽  
Therapeutic Value

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.

scholarly journals Regional differences in general practitioners’ behaviours regarding influenza vaccination: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonathan Arlt ◽  
Kristina Flaegel ◽  
Katja Goetz ◽  
Jost Steinhaeuser
Keyword(s):  
Influenza Vaccination ◽  
General Practitioners ◽  
Personal Characteristics ◽  
Cross Sectional Study ◽  
Central Research Institute ◽  
World Health ◽  
Central Research ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Health Organization

Abstract Background The World Health Organization recommends vaccination rates of 75% against seasonal influenza for patients over 65 years old. In the 2013/2014 season, the German vaccination rates ranged between 14 and 65%. This study aimed to compare the attitudes, personal characteristics and vaccination behaviours of general practitioners (GPs) in regions with high and low vaccination rates in Germany. Methods In May 2016, a questionnaire was sent to 1594 GPs practising in 16 districts with the highest and the lowest vaccination rates in Western and Eastern Germany as described by the Central Research Institute of Ambulatory Health Care in Germany for the 2013/2014 season. Descriptive statistics and multiple regression analyses were computed to identify potential factors associated with high vaccination rates. Results A total response rate of 32% (515/1594 participants) was observed in the study. GPs reported their attitudes towards vaccination in general and vaccination against influenza as mostly ‘very positive’ (80%, n = 352 and 65%, n = 288, respectively). GPs practising in regions with low vaccination rates reported their attitudes towards vaccinations in general (p = 0.004) and towards influenza vaccination (p = 0.001) more negatively than their colleagues from regions with high vaccination rates. Multiple logistic regression identified an increasing influence of year-dependent changing efficiency on GPs’ influenza rates as the strongest factor for predicting GPs from highly vaccinating regions (OR = 4.31 [1.12–16.60]), followed by the patient’s vaccination refusal despite GP advice due to already receiving a vaccination from another physician (OR = 3.20 [1.89–5.43]) and vaccination information gathering through medical colleagues (OR = 2.26 [1.19–4.29]). Conclusions The results of this study suggest a correlation between GPs’ attitudes and regional vaccination rates. Beneath GPs’ individual attitudes, the regional attitude patterns of patients, colleagues and medical assistants surrounding those GPs seem decisive and should be integrated into future campaigns to increase vaccination rates at a regional level.

scholarly journals Patients with nodding syndrome in Uganda improve with symptomatic treatment: a cross-sectional study

BMJ Open ◽  
2014 ◽  
Vol 4 (11) ◽  
pp. e006476 ◽  
Author(s):  
Richard Idro ◽  
Hanifa Namusoke ◽  
Catherine Abbo ◽  
Byamah B Mutamba ◽  
Angelina Kakooza-Mwesige ◽  
...  
Keyword(s):  
Symptomatic Treatment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nodding Syndrome

scholarly journals Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Kersting ◽  
Lena Zimmer ◽  
Anika Thielmann ◽  
Birgitta Weltermann
Keyword(s):  
Regression Model ◽  
General Practitioners ◽  
Chronic Stress ◽  
Medical Records ◽  
High Strain ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Work Related

Abstract Background The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. Methods This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. Results Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29–19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. Conclusions This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

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