Novartis Pharma GmbH, Roonstr. 25, 90429, Nuremberg, Germany.
Christian Hospital Unna, Unna, Germany.
J Headache Pain. 2021 Sep 9;22(1):106. doi: 10.1186/s10194-021-01316-5.
Migraine is a primary headache disorder characterized by recurrent attacks that may have a significant impact on patients' daily life. Treatment options must often be re-evaluated in light of efficacy, tolerability and compliance issues. Few data on commonly applied treatment algorithms and treatment failures have existed in Germany in 2017/2018. The PANORAMA survey was designed to explore and characterize the migraine healthcare landscape and to demonstrate the medical treatment need at that time in Germany.
Three different questionnaires were used to assess the profile of the 119 participating centers, characterize migraine patients at centers and evaluate qualitative aspects of the current migraine healthcare situation from a physician´s professional perspective. Data were analyzed as observed and summarized by descriptive statistics.
The results demonstrate that once referred to a migraine specialist, the majority of patients continue to be treated at a specialist. At specialized centers, 41.6 % of migraine patients receive prophylactic treatment. 45.4 % of prophylactic treatments are initiated with a beta-blocker and 28.1 % with an anti-epileptic. Pivotal factors to initiate prophylactic treatment are migraine attack frequency and intensity (58.0 %). Treatment decisions are largely based on prior / concomitant diseases and physical constitution of the patient (52.1 %). Following an inadequate treatment, most patients either switch substance class or discontinue prophylactic treatment.
PANORAMA gives a comprehensive overview of the migraine healthcare landscape in Germany in 2017/2018, elucidates a lack of common treatment algorithms and reveals a high demand for defined therapy strategies and new prophylactic treatment going forwards.
偏头痛是一种主要的头痛疾病，其特征是反复发作，可能对患者的日常生活产生重大影响。治疗方案必须经常根据疗效、耐受性和依从性问题进行重新评估。2017/2018 年，德国很少有关于常用治疗方案和治疗失败的数据。PANORAMA 调查旨在探讨和描述偏头痛医疗保健状况，并展示当时德国的医疗需求。
使用三种不同的问卷评估了 119 个参与中心的概况，描述了中心的偏头痛患者特征，并从医生的专业角度评估了当前偏头痛医疗保健状况的定性方面。数据以观察和描述性统计进行分析。
结果表明，一旦被转诊给偏头痛专家，大多数患者将继续在专家处接受治疗。在专门的中心，41.6%的偏头痛患者接受预防性治疗。预防性治疗的 45.4%是用β受体阻滞剂开始的，28.1%是用抗癫痫药开始的。启动预防性治疗的关键因素是偏头痛发作的频率和强度（58.0%）。治疗决策主要基于既往/并存疾病和患者的身体状况（52.1%）。在治疗效果不佳后，大多数患者要么改变药物类别，要么停止预防性治疗。
PANORAMA 全面概述了 2017/2018 年德国的偏头痛医疗保健状况，阐明了缺乏常见治疗方案，并揭示了对明确治疗策略和新预防性治疗的高需求。
