与偏头痛患者在头痛专家建议下开始行为性偏头痛治疗的决定相关的因素：一项前瞻性观察研究。
Factors Related to Migraine Patients' Decisions to Initiate Behavioral Migraine Treatment Following a Headache Specialist's Recommendation: A Prospective Observational Study.
机构信息
Department of Neurology.
Department of Population Health.
出版信息
Pain Med. 2018 Nov 1;19(11):2274-2282. doi: 10.1093/pm/pny028.
OBJECTIVE
To evaluate the frequency with which migraine patients initiated behavioral migraine treatment following a headache specialist recommendation and the predictors for initiating behavioral migraine treatment.
METHODS
We conducted a prospective cohort study of consecutive patients diagnosed with migraine to examine whether the patients initiated behavioral migraine treatment following a provider recommendation. The primary outcome was scheduling the initial visit for behavioral migraine treatment. Patients who initiated behavioral migraine treatment were compared with those who did not (demographics, migraine characteristics, and locus of control) with analysis of variance and chi-square tests.
RESULTS
Of the 234 eligible patients, 69 (29.5%) were referred for behavioral treatment. Fifty-three (76.8%) patients referred for behavioral treatment were reached by phone. The mean duration from time of referral to follow-up was 76 (median 76, SD = 45) days. Thirty (56.6%) patients initiated behavioral migraine treatment. There was no difference in initiation of behavioral migraine treatment with regard to sex, age, age of diagnosis, years suffered with headaches, health care utilization visits, Migraine Disability Assessment Screen, and locus of control (P > 0.05). Patients who had previously seen a psychologist for migraine were more likely to initiate behavioral migraine treatment than patients who had not. Time constraints were the most common barrier cited for not initiating behavioral migraine treatment.
CONCLUSIONS
Less than one-third of eligible patients were referred for behavioral treatment, and only about half initiated behavioral migraine treatment. Future research should further assess patients' decisions regarding behavioral treatment initiation and methods for behavioral treatment delivery to overcome barriers to initiating behavioral migraine treatment.
目的
评估偏头痛患者在头痛专家建议后开始行为性偏头痛治疗的频率，以及预测开始行为性偏头痛治疗的因素。
方法
我们对连续确诊为偏头痛的患者进行了前瞻性队列研究，以检验患者是否根据医生的建议开始行为性偏头痛治疗。主要结局是安排行为性偏头痛治疗的初始就诊。通过方差分析和卡方检验，比较了开始行为性偏头痛治疗的患者与未开始治疗的患者（人口统计学、偏头痛特征和控制源）。
结果
在 234 名符合条件的患者中，有 69 名（29.5%）被推荐进行行为治疗。53 名（76.8%）被推荐进行行为治疗的患者通过电话联系上了。从转诊到随访的平均时间为 76 天（中位数为 76，标准差=45）。30 名（56.6%）患者开始了行为性偏头痛治疗。在性别、年龄、偏头痛诊断年龄、头痛发作年数、医疗保健利用就诊次数、偏头痛残疾评估量表和控制源方面，开始行为性偏头痛治疗的差异无统计学意义（P＞0.05）。曾因偏头痛看过心理医生的患者比未看过心理医生的患者更有可能开始行为性偏头痛治疗。时间限制是未开始行为性偏头痛治疗的最常见障碍。
结论
不到三分之一的符合条件的患者被推荐进行行为治疗，只有约一半的患者开始行为性偏头痛治疗。未来的研究应进一步评估患者对开始行为性偏头痛治疗的决定，以及克服开始行为性偏头痛治疗障碍的行为治疗方法。
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