Ching Siew Mooi, Yong Fung Lin, Jao Hsiao Wei, Santiago-Dayanghirang Jecyll, Shinde Salil Prakash, Setia Sajita
Family Medicine, Universiti Putra Malaysia, Serdang, MYS.
Medical Affairs, Pfizer Malaysia, Kuala Lumpur, MYS.
Cureus. 2024 Dec 8;16(12):e75337. doi: 10.7759/cureus.75337. eCollection 2024 Dec.
Migraine is a common neurological disorder that presents considerable challenges to healthcare systems worldwide. These changes are especially relevant in rapidly developing regions such as Asia, with an increasingly productive population and ongoing advancements in healthcare systems and infrastructure. Despite its substantial impact, migraine management remains inadequate, potentially due to deficiencies in medical education. We hypothesized that significant gaps in basic and advanced medical training and continuing professional education contribute to the suboptimal management of migraine in various healthcare settings across Asia. A comprehensive literature review was conducted using PubMed and Google databases. The search focused on cross-sectional studies published in English from inception until September 2024 that examined educational needs among medical trainees and clinicians and clinical gaps in migraine management in Asia. These studies were then contextualized within a global perspective. The review identified significant shortcomings in migraine education at all levels of educational training in Asia, which also translated to poor management of migraines in clinical practice. Undergraduate medical curricula in Asia inadequately address headache disorders, while postgraduate training programs provide insufficient guidance in headache management, especially for complex cases. Primary care clinicians exhibited variable levels of understanding and frequently incorrectly diagnosed and managed migraine. Additionally, many Asian countries lack standardized clinical practice guidelines (CPGs) and specialized training programs for headache management. A multidimensional approach is required to tackle the pre-existing educational and clinical practice limitations. The approach should include improving the medical school curriculum, providing focused continuing medical education programs or developing migraine modules for primary care physicians (PCPs), and developing region-specific CPGs. Besides educational initiatives, integrating and coordinating systems of care, where primary and specialist services complement each other, are crucial for improving patient care. Robust education combined with comprehensive referral and linkage protocols ensures continuity of care across healthcare levels. Moreover, collaboration, communication, and cooperation among healthcare providers (HCPs) and organizations are vital to enhancing the quality of life and productivity of migraine patients in the region. A synergistic approach that combines robust collaboration with innovative educational delivery can catalyze the widespread adoption of evidence-based medicine (EBM).
偏头痛是一种常见的神经系统疾病,给全球医疗系统带来了巨大挑战。这些变化在亚洲等快速发展的地区尤为显著,因为该地区人口生产力不断提高,医疗系统和基础设施也在持续发展。尽管偏头痛影响重大,但由于医学教育的不足,其管理仍然不够完善。我们推测,基础和高级医学培训以及继续职业教育方面的显著差距导致了亚洲各地不同医疗环境中偏头痛管理的不理想。我们使用PubMed和谷歌数据库进行了全面的文献综述。搜索重点是从开始到2024年9月以英文发表的横断面研究,这些研究考察了医学实习生和临床医生的教育需求以及亚洲偏头痛管理中的临床差距。然后将这些研究置于全球视角下进行背景分析。该综述发现,亚洲各级教育培训在偏头痛教育方面存在重大缺陷,这也导致临床实践中偏头痛管理不善。亚洲的本科医学课程对头痛疾病的关注不足,而研究生培训项目在头痛管理方面提供的指导不够,尤其是对于复杂病例。初级保健临床医生的理解水平参差不齐,经常对偏头痛进行错误诊断和管理。此外,许多亚洲国家缺乏头痛管理的标准化临床实践指南(CPG)和专门培训项目。需要采取多维度方法来解决现有的教育和临床实践局限性。该方法应包括改进医学院课程、提供针对性的继续医学教育项目或为初级保健医生(PCP)开发偏头痛模块,以及制定针对特定地区的CPG。除了教育举措外,整合和协调护理系统(其中初级和专科服务相互补充)对于改善患者护理至关重要。强大的教育与全面的转诊和联系协议相结合,可确保跨医疗层次的护理连续性。此外,医疗服务提供者(HCP)和组织之间的协作、沟通与合作对于提高该地区偏头痛患者的生活质量和生产力至关重要。将强大的协作与创新的教育交付相结合的协同方法可以促进循证医学(EBM)的广泛应用。