Seng Elizabeth, Lampl Christian, Viktrup Lars, Lenderking William R, Karn Hayley, Hoyt Margaret, Kim Gilwan, Ruff Dustin, Ossipov Michael H, Vincent Maurice
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
Department of Neurology, Konventhospital Barmherzige Brüder Linz, Linz, Austria.
Pain Ther. 2024 Dec;13(6):1589-1615. doi: 10.1007/s40122-024-00652-z. Epub 2024 Sep 19.
Migraine is under-diagnosed and under-treated. Many people with migraine do not seek medical care, and those who do may initially receive a different diagnosis and/or be dissatisfied with provided care on their journey before treatment with a CGRP-mAb (calcitonin-gene-related-peptide monoclonal antibody).
This is a cross-sectional, self-reported, online survey of subjects in Lilly's Emgality Patient Support Program in 2022. Questionnaires collected insights into subjects' prior experiences with migraine and interactions with healthcare professionals before receiving CGRP-mAbs.
Of the 250 participants with episodic and 250 with chronic migraine, 90% were female and white with a mean age of 26.2 years (± 11.9) at diagnosis and 40.6 (± 12.0) years at survey enrollment. Many participants (71%) suspected they had migraine before diagnosis, with 31% reluctant to seek help. Of these, approximately one-third were unaware of treatment, did not think that a physician could do anything more for migraine, would not take them seriously, or were reluctant due to a previous unhelpful experience. Participants mainly received information from friends/family (47%) or the internet (28%). Participants initially sought treatment due to an increase in migraine frequency (77%), attacks interfering with work or school (75%), or increased pain intensity (74%). Subjects saw a mean of 4.1 (± 4.3) healthcare providers before migraine diagnosis, and 20% of participants previously received a different diagnosis. Participants reported migraine causes included stress/anxiety/depression (42%), hormonal changes (30%), nutrition (20%), and weather (16%). Acute treatment of migraine included prescription (82%) and over-the-counter (50%) medications, changes in nutrition (62%), adjusting fluid intake (56%), and relaxation techniques (55%). Preventive medications included anticonvulsants (61%), antidepressants (44%), blood pressure-lowering medications (43%), and botulinum toxin A injections (17%). Most discontinuations were due to lack of efficacy or side effects.
People with migraine describe reluctance in seeking health care, and misunderstandings seem common especially in the beginning of their migraine journey. Graphical abstract available for this article.
偏头痛的诊断和治疗不足。许多偏头痛患者不寻求医疗护理，而那些寻求医疗护理的患者在接受降钙素基因相关肽单克隆抗体（CGRP - mAb）治疗之前，可能最初会得到不同的诊断，和/或在就医过程中对所提供的护理不满意。
这是一项对礼来公司2022年Emgality患者支持项目中的受试者进行的横断面、自我报告的在线调查。问卷收集了受试者在接受CGRP - mAb治疗之前偏头痛的既往经历以及与医疗保健专业人员互动的相关见解。
在250名发作性偏头痛患者和250名慢性偏头痛患者中，90%为女性且是白人，诊断时的平均年龄为26.2岁（±11.9），调查入组时的平均年龄为40.6岁（±12.0）。许多参与者（71%）在诊断前怀疑自己患有偏头痛，其中31%不愿寻求帮助。在这些人中，约三分之一不知道有治疗方法，认为医生对偏头痛无能为力，医生不会认真对待他们，或者因之前的不愉快经历而不愿寻求帮助。参与者主要从朋友/家人（47%）或互联网（28%）获取信息。参与者最初因偏头痛发作频率增加（77%）、发作干扰工作或学习（75%）或疼痛强度增加（74%）而寻求治疗。在偏头痛诊断之前，受试者平均看了4.1名（±4.3）医疗保健提供者，20%的参与者之前得到过不同的诊断。参与者报告的偏头痛诱发因素包括压力/焦虑/抑郁（42%）、激素变化（30%）、营养（20%）和天气（16%）。偏头痛的急性治疗包括处方药（82%）和非处方药（50%）、营养改变（62%）、调整液体摄入量（56%）和放松技巧（55%）。预防性药物包括抗惊厥药（61%）、抗抑郁药（44%）、降压药（43%）和肉毒杆菌毒素A注射（17%）。大多数停药是由于缺乏疗效或出现副作用。
偏头痛患者表示不愿寻求医疗护理，误解似乎很常见，尤其是在偏头痛病程开始时。本文提供了图形摘要。
