Naprienko M V, Latysheva N V, Artemenko A R, Osipova V V, Tabeeva G R, Filatova E G, Akhmadeeva L R, Smekalkina L V
Alexander Vein Headache Clinic, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(1):83-89. doi: 10.17116/jnevro202012001183.
To study the compliance of neurologists and headache specialists to chronic headache and chronic migraine (CM) diagnosis and treatment guidelines.
The survey included 634 neurologists from all regions of the Russian Federation. Mean age of respondents was 40.7±8.5 years, mean years of experience 14.2±7.8 years.
Most doctors work in outpatient or hospital settings (49% and 24%, respectively), 7% were headache specialists. Tension-type headache (TTH) was diagnosed in 30% and CM in 17% of patients while 44% of patients were presumed to have a mixed headache disorder (TTH+CM). Only 10% of physicians do not use instrumental diagnostic methods in chronic headache. This study has shown sufficient attention to comorbid conditions and frequent prescription of headache preventative treatment. Botox prescription data is equivocal: 35% of physicians recommend such treatment, 27% do not, while other doctors prescribe it for off-label indications.
To overcome clinical inertia, further education in chronic headaches and their optimal treatment is warranted.
研究神经科医生和头痛专科医生对慢性头痛和慢性偏头痛（CM）诊断与治疗指南的依从性。
该调查纳入了来自俄罗斯联邦所有地区的634名神经科医生。受访者的平均年龄为40.7±8.5岁，平均工作年限为14.2±7.8年。
大多数医生在门诊或医院工作（分别为49%和24%），7%为头痛专科医生。30%的患者被诊断为紧张型头痛（TTH），17%的患者被诊断为CM，而44%的患者被推测患有混合性头痛障碍（TTH+CM）。只有10%的医生在慢性头痛中不使用仪器诊断方法。这项研究表明对合并症给予了足够的关注，并且头痛预防性治疗的处方频率较高。肉毒杆菌毒素的处方数据不明确：35%的医生推荐这种治疗，27%的医生不推荐，而其他医生将其用于非标签适应症。
为克服临床惰性,有必要对慢性头痛及其最佳治疗方法进行进一步教育。
