Læknablaðið - 15.06.2009, Side 25

FRÆÐIGREINAR
RANNSÓKN
verklagi sínu vitandi af því að rannsókn væri í
gangi. Veikleikar rannsóknarinnar eru hins vegar
þeir að ekki er hægt að fullyrða almennt um
faraldsfræðilegar upplýsingar eins og algengi
mígrenis á íslandi og jafnframt er vafalaust
nokkur hópur sjúklinga með mígreni sem ekki
nýtir sér þjónustu á heilsugæslustöð og við höfum
því ekki upplýsingar um.
Niðurstöður rannsóknarinnar sýna að talsvert
stór hópur fólks fær greiningu og meðferð vegna
mígrenis á heilsugæslustöð á Islandi. Miðað við
algengistölur erlendis frá, í faraldsfræðilegum
rannsóknum, er þó ljóst að ákveðinn hluti
mígrenisjúklinga virðist ekki leita til heimilis-
læknis vegna greiningar eða meðferðar. Með
markvissari greiningu mígrenisjúklinga er líklegt
að draga mætti eitthvað úr notkun tölvu-
sneiðmynda af höfði. Lyfjanotkun er mikil og út-
breidd hjá þessum sjúklingahópi og algengustu
lyfjaflokkamir sem læknar ávísuðu voru triptan-
lyf, NSAID og verkjalyf sem innihalda kódein.
Þakkir
Rannsókn þessi var að hluta til styrkt af
Vísindasjóði Félags íslenskra heimilislækna.
Sérstakar þakkir fær Guðný Sigurvinsdóttir
læknaritari fyrir aðstoð við vinnslu gagna.
Heimildir
1. McConaghy JR. Headache in primary care. Prim Care 2007;
34: 83-97.
2. Fuller G, Kaye C. Headaches. BMJ 2007; 334: 254-6.
3. Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed
M. Prevalence and burden of migraine in the United States:
data from the American Migraine Study II. Headache 2001;
41: 646-57.
4. Dahlöf C, Linde M. One-year prevalence of migraine in
Sweden: a population-based study in adults. Cephalalgia
2001;21:664-71.
5. Menken M, Munsat TL, Toole JF. The global burden of
disease study: implications for neurology. Arch Neurol 2000;
57: 418-20.
6. Belam J, Harris G, Kemick D, et al. A qualitative study of
migraine involving patient researchers. Br J Gen Pract 2005;
55: 87-93.
7. Landy SHM, Kwong WJP, Hutchinson SM, Roselli AM,
Burch SP. Migraine: a better way to recognize and treat it. J
Fam Pract 2006; 55:1038-47.
8. Lipton RB, Diamond S, Reed M, Diamond ML, Stewart
WF. Migraine diagnosis and treatment: results from the
American Migraine Study II. Headache 2001; 41: 638-45.
9. Bigal ME, Kolodner KB, Lafata JE, Leotta C, Lipton RB.
Patterns of medical diagnosis and treatment of migraine and
probable migraine in a health plan. Cephalalgia 2006; 26:43-
9.
10. MacGregor EA. The doctor and the migraine patient:
improving compliance. Neurology 1997;48(SUPPL 3):S16-
20.
11. Kaniecki RG. Migraine and tension-type headache: an
assessment of challenges in diagnosis. Neurology 2002; 58:
S15-20.
12. The International Classification of Headache Disorders: 2nd
edition. Cephalalgia 2004;24 Suppl 1:9-160.
13. Mehle MEMF, Schreiber CP. Sinus headache, migraine, and
the otolaryngologist. Otolaryngol Head Neck Surg 2005;
133:489-96.
14. Schreiber CPM, Hutchinson SM, Webster CJB, Ames MP,
Richardson MSPB, Powers CB. Prevalence of migraine
in patients with a history of self-reported or physician-
diagnosed "sinus" headache. Arch Intem Med 2004; 164:
1769-72.
15. Lipton RB, Stewart WF, Scher AI. Epidemiology and
economic impact of migraine. Curr Med Res Opin 2001;17
Suppl l:s4-12.
16. Lipton RBM, Bigal ME. Ten lessons on the epidemiology of
migraine. Headache 2007;47(Suppl l):S2-9.
17. Ebell MH. Diagnosis of migraine headache. Am Fam
Physician 2006; 74: 2087-8.
18. Smetana GW. The diagnostic value of historical features
in primary headache syndromes: a comprehensive review.
Arch Intern Med 2000; 160: 2729-37.
19. Launer LJ, Terwindt GM, Ferrari MD. The prevalence and
characteristics of migraine in a population-based cohort: the
GEM study. Neurology 1999; 53: 537-42.
20. Evans RWM, Olesen JMP. Migraine classification, diagnostic
criteria, and testing. Neurology 2003; 60:S24-30.
21. Lipton RM, Bigal MMP, Rush SML, et al. Migraine practice
pattems among neurologists. Neurology 2004; 62:1926-31.
22. Detsky MEB, McDonald DRB, Baerlocher MOM, et al.
Does this patient with headache have a migraine or need
neuroimaging? JAMA 2006; 296:1274-83.
23. Scottish Intercollegiate Guidelines Network (SIGN).
Diagnosis and management of headache in adults. A
national clinical guideline. 2008.
24. Landy SH. Challenging or difficult headache patients. Prim
Care 2004; 31: 429-40. VIII.
25. Facco E, Liguori A, Petti F, et al. Traditional acupuncture in
migraine: a controlled, randomized study. Headache 2008;
48: 398-407.
26. Maeno TM, Inoue KMP, Yamada KM, Maeno TMP, Sato
TMP. Indicators of a major depressive episode in primary
care patients with a chief complaint of headache. Headache
2007; 47:1303-10.
27. Radat F, Mekies C, Geraud G, et al. Anxiety, stress and
coping behaviours in primary care migraine patients: results
of the SMILE study. Cephalalgia 2008; 28:1115-25.
28. Líndal E, Stefánsson JG. The lifetime prevalence of anxiety
disorders in Iceland as estimated by the US National
Institute of Mental Health Diagnostic Interview Schedule.
Acta Psychiatr Scand 1993; 88: 29-34.
29. Benediktsdóttir B, Tómasson K, Gíslason Þ. Einkenni
breytingaskeiðs og meðferð þeirra hjá 50 ára íslenskum
konum. Læknablaðið 2000; 86: 501-7.
30. Goadsby PJ, Lipton RB, Ferrari MD. Migraine-current
understanding and treatment. N Engl J Med 2002; 346: 257-
70.
31. Aukerman G, Knutson D, Miser WF. Management of the
acute migraine headache. Am Fam Physician 2002; 66: 2123-
30.
32. Goadsby PJ. Recent advances in the diagnosis and
management of migraine. BMJ 2006; 332: 25-9.
33. Walling AD, Woolley DC, Molgaard C, Kallail KJ.
Patient satisfaction with migraine management by family
physicians. J Am Board Fam Pract 2005; 18: 563-6.
34. Diener HC, Tfelt-Hansen P, de Beukelaar F, et al. The
efficacy and safety of sc alniditan vs. sc sumatriptan in the
acute treatment of migraine: a randomized, double-blind,
placebo-controlled trial. Cephalalgia 2001; 21: 672-9.
35. Dahlöf CG, Lipton RB, McCarroll KA, Kramer MS, Lines
CR, Ferrari MD. Within-patient consistency of response of
rizatriptan for treating migraine. Neurology 2000; 55: 1511-
6.
LÆKNAblaðið 2009/95 437