Zebenholzer Karin, Andree Colette, Lechner Anita, Broessner Gregor, Lampl Christian, Luthringshausen Gernot, Wuschitz Albert, Obmann Sonja-Maria, Berek Klaus, Wöber Christian
Department of Neurology, Medical University of Vienna, Vienna, Austria,
J Headache Pain. 2015;16:531. doi: 10.1186/s10194-015-0531-7. Epub 2015 May 19.
Episodic and chronic headaches (EH, CH) are highly prevalent disorders. Severely affected patients are usually referred to headache centres. In Austria, at least one headache centre is available in seven of nine states, but detailed multicentre data are missing. Therefore we studied prevalence rates, use of medication and health care services, impact of headaches, and comorbid depression and anxiety.
We included consecutive patients from eight Austrian outpatient headache centres. The patients filled-in the Eurolight questionnaire. In addition, the treating neurologist completed a questionnaire on clinical diagnoses and ever-before prophylactic medications.
Of 598 patients screened, 441 questionnaires were analysed (79 % female, mean age 41.1 years). According to the Eurolight algorithm, 56.4 % of the patients had EH, 38.3 % had CH and 5.2 % did not give their headache frequency. The prevalence rates of migraine, tension-type headache, and probable medication overuse headache (pMOH) were 48.5 %, 6.3 % and 15.9 %, respectively. The concordance between clinical and Eurolight diagnoses was good for EH and moderate for CH. During the preceding month, acute medication was used by 90.9 % of the patients and prophylactic medication by 34 %. Ever-before use of five standard prophylactic drugs was recorded in 52.3 %. The proportion of patients with current pharmacoprophylaxis did not differ in EH and CH, whereas ever-before use was more common in CH (62.5 % was 45,3 %, p = 0.02). Patients with CH significantly more often consulted general practitioners and emergency departments, had a lower quality of life and more often signs of depression and anxiety.
This study provides comprehensive data from eight Austrian headache centres for the first time. We found a substantial number of patients with CH including pMOH and its association with more common utilization of health care facilities and greater burden. The low use of prophylactic medication requires further examination.
发作性和慢性头痛（EH，CH）是非常常见的疾病。严重受影响的患者通常会被转诊至头痛中心。在奥地利，九个州中有七个州至少有一个头痛中心，但缺乏详细的多中心数据。因此，我们研究了患病率、药物使用和医疗服务利用情况、头痛的影响以及合并的抑郁和焦虑情况。
我们纳入了来自奥地利八个门诊头痛中心的连续患者。患者填写了Eurolight问卷。此外，主治神经科医生完成了一份关于临床诊断和既往预防性药物使用情况的问卷。
在筛查的598例患者中，分析了441份问卷（79%为女性，平均年龄41.1岁）。根据Eurolight算法，56.4%的患者患有EH，38.3%患有CH，5.2%未提及头痛频率。偏头痛、紧张型头痛和可能的药物过度使用性头痛（pMOH）的患病率分别为48.5%、6.3%和15.9%。临床诊断与Eurolight诊断之间的一致性对于EH良好，对于CH中等。在前一个月，90.9%的患者使用了急性药物，34%使用了预防性药物。52.3%的患者有过使用五种标准预防性药物的记录。当前进行药物预防的患者比例在EH和CH中没有差异，而既往使用在CH中更常见（62.5%对45.3%，p = 0.02）。CH患者更常咨询全科医生和急诊科，生活质量较低，抑郁和焦虑症状更常见。
本研究首次提供了来自奥地利八个头痛中心的综合数据。我们发现大量CH患者，包括pMOH患者，及其与更频繁使用医疗设施和更大负担的关联。预防性药物使用不足需要进一步研究。
