Cvetković Vlasta Vuković
Acta Med Croatica. 2013 Dec;67(5):415-24.
According to the epidemiological study conducted in Croatia, 15% of the population suffer from migraine, 20.6% from tension-type headache and 2.4% from chronic headache. Although migraine is a frequent primary headache and poses a major problem to both the affected individuals and the society, it is considered that migraine is underdiagnosed. The study revealed half of patients with headache and even 36.3% of respondents with migraine to have never visited a doctor. Migraine and tension-type headache are not satisfactorily treated; in the study, one-quarter of the respondents were fully satisfied with the treatment of their headaches, approximately half were partially satisfied, one-fifth were mostly unsatisfied, and 10% were completely unsatisfied. It should be noted that specific therapy for migraine attacks, i.e. triptans, are available on the market and can be administered for moderate and severe headache attacks. Triptans are prescribed rarely, not only in Croatia but also in the world, although studies have shown that the use of triptans increases productivity at work and improves the quality of life in migraineurs. Prophylaxis may significantly improve the quality of life; the Croatian epidemiological study showed only 14% of respondents with migraine to have ever used prophylactic therapy. Considering that migraine is an 'expensive disorder', appropriate treatment of patients with migraine will decrease the costs that include visits to general practitioners, emergency departments and cost of hospitalization. Even indirect costs will decrease as well, including the costs caused by absenteeism from work and costs caused by reduced efficiency at work. It is necessary to educate the population about migraine and therapeutic options. Lack of time, unrecognized patients and insufficient knowledge about current treatment of migraine and other primary headaches are probably the reasons why patients do not receive appropriate therapy. Continuous campaigns, which should include lectures and workshops for physicians and inclusion of media for better spread of information about primary headaches among the population should be encouraged.
根据在克罗地亚进行的流行病学研究，15%的人口患有偏头痛，20.6%患有紧张型头痛，2.4%患有慢性头痛。尽管偏头痛是一种常见的原发性头痛，给患者个人和社会都带来了重大问题，但人们认为偏头痛存在诊断不足的情况。该研究显示，一半的头痛患者，甚至36.3%的偏头痛受访者从未看过医生。偏头痛和紧张型头痛的治疗效果并不理想；在该研究中，四分之一的受访者对其头痛治疗完全满意，约一半部分满意，五分之一大多不满意，10%完全不满意。应该指出的是，市场上有针对偏头痛发作的特效疗法，即曲坦类药物，可用于治疗中度和重度头痛发作。曲坦类药物的处方很少，不仅在克罗地亚如此，在全世界也是如此，尽管研究表明使用曲坦类药物可提高工作效率并改善偏头痛患者的生活质量。预防性治疗可显著提高生活质量；克罗地亚的流行病学研究表明，只有14%的偏头痛受访者曾使用过预防性治疗。鉴于偏头痛是一种“昂贵的疾病”，对偏头痛患者进行适当治疗将降低包括看全科医生、去急诊科以及住院费用在内的成本。甚至间接成本也会降低，包括因旷工造成的成本和因工作效率降低造成的成本。有必要对公众进行偏头痛及治疗选择方面的教育。时间不足、患者未被识别以及对偏头痛和其他原发性头痛当前治疗方法的了解不足，可能是患者未得到适当治疗的原因。应鼓励开展持续的宣传活动，其中应包括为医生举办讲座和研讨会，并利用媒体更好地向公众传播有关原发性头痛的信息。
