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Læknablaðið - 15.06.2009, Síða 25

Læknablaðið - 15.06.2009, Síða 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. 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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

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