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Initial situation and approach to the care of migraine in neurology services in Spain. The PRIMERA study

V. Mateos-Marcos, J. Porta-Etessam, S. Armengol-Bertolín, C. Larios, M. Garcia-Garcia, en representación de los investigadores del estudio PRIMERA [REV NEUROL 2012;55:577-584] PMID: 23143958 DOI: https://doi.org/10.33588/rn.5510.2012295

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Volumen 55 | Number 10 | Nº of views of the article 6.417 | Nº of PDF downloads 953 | Article publication date 16/11/2012

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ABSTRACT

INTRODUCTION Despite the high degree of disability it entails, many patients with migraine have never visited their doctor for this reason. It is necessary to conduct a study to examine the characteristics of first-time visits as a step that must be carried out prior to establishing specific intervention measures for this group of patients.

AIM To determine the profile of the patients with migraine who visit a neurology service for the first time, together with the diagnostic and therapeutic attitudes that neurologists display towards them.

PATIENTS AND METHODS We conducted a cross-sectional, multi-centre study of neurology services across the country. The research included 168 neurologists who recruited 851 patients (74.6% females; mean age: 34.0 ± 10.7 years). Disability was assessed by means of the specific migraine questionnaire (Headache Impact Test) and the generic disability questionnaire (Sheehan Disability Scale).

RESULTS A third (66.5%) of the patients went for consultation following their doctor’s advice, while the remaining 33.5% went on their own accord. Only 55.9% had been previously diagnosed with migraine. The main reasons for visiting were ineffective symptomatic treatment (25%) and an increase in the frequency or intensity of the attacks (23.4%). Although 70.3% of the patients had high disability scores on the Headache Impact Test, only 17.4% used specific treatment and only 13.3% were on preventive treatment.

CONCLUSIONS The PRIMERA study confirms, once again, that migraine is an under-diagnosed and under-treated condition in our setting, which means that specific educational interventions and training are still required for this pathology. KeywordsClinical-epidemiological profile Diagnosis Headaches Migraine Neurologist Treatment CategoriesCefalea y Migraña Dolor

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Initial situation and approach to the care of migraine in neurology services in Spain. The PRIMERA study