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2018年至2022年哥伦比亚队列中偏头痛患者的流行病学、临床特征及治疗模式

Epidemiological, clinical characterization and treatment patterns of migraine patients in a Colombian cohort from 2018 to 2022.

作者信息

Rubio A C, Arciniegas J A, Bolanos-Lopez J E, Gonzalez F J, Gomez D, Mesa A, Bello C, Garcia M, Perez L E, Reyes J M

机构信息

Pfizer SAS, Bogota, Colombia.

Suramericana IPS, Medellin, Colombia.

出版信息

J Headache Pain. 2024 Dec 24;25(1):226. doi: 10.1186/s10194-024-01918-9.

Abstract

BACKGROUND

To describe the epidemiology and clinical characteristics of migraine and the status of treatment in Colombia. Additionally, the use of health resources by patients was measured.

METHODS

This was a non-interventional, retrospective, descriptive study conducted in one Colombian Health Management Organization (HMO) from 2018 to 2022 with a follow-up period of 5 years. Migraine patients were identified using the International Code Disease 10th version G43, and the diagnosis was confirmed by a neurologist. The first recorded migraine diagnosis was defined as the index date. Medical records, claim databases and other electronic databases from the HMO were used to determine the clinical characteristics, treatments, and health care services.

RESULTS

A total of 89,227 patients were included in the study. The mean follow-up period was 3.7 years (standard deviation 1.2). Most of them were women (84.9%). Many patients were first seen by a general practitioner (82.6%), and only 8.9% were first seen by a neurologist. The prevalence of migraine during follow-up was between 1.69 and 2.42 patients in 100 HMO affiliates in 2020, the year with the highest prevalence (2.42 [95% CI 2.41-2.44]), and the incidence ranged from 0.032 to 1.72 per 100 patient-year at risk of developing migraine. Hypertension (21.3%), arrythmia (4.1%) and structural heart disease (3.4%) were the most common cardiovascular diseases. The annual mean number of outpatient consultations in 2018 was 1.43 consultations per patient, which decreased to 0.68 in 2022. The most frequent treatments for acute events were nonsteroidal anti-inflammatory drugs (NSAIDs) (range 37-42%) in monotherapy, combinations of analgesics (range 14-35%), and corticosteroids (range 10-15%). Triptans were used in 4% of patients in the first medication record, reaching a maximum of 16% of patients. Among preventive treatments, beta-blockers (24-49%) and antiepileptics (29-41%) were the most common.

CONCLUSION

The prevalence of migraine in Colombia according to health electronic databases was lower than that reported in previous studies conducted in the country. The treatment patterns for acute and preventive treatment of migraine follow the recommendations of different guidelines. Cardiovascular disease is relevant for the management of migraine.

摘要

背景

描述哥伦比亚偏头痛的流行病学、临床特征及治疗现状。此外,还对患者使用卫生资源的情况进行了评估。

方法

这是一项非干预性、回顾性描述性研究,于2018年至2022年在哥伦比亚一家健康管理组织(HMO)开展,随访期为5年。使用国际疾病分类第10版G43识别偏头痛患者,诊断由神经科医生确认。首次记录的偏头痛诊断日期定义为索引日期。利用HMO的病历、理赔数据库及其他电子数据库确定临床特征、治疗方法和医疗服务情况。

结果

共纳入89227例患者。平均随访期为3.7年(标准差1.2)。其中大多数为女性(84.9%)。许多患者首诊于全科医生(82.6%),仅8.9%的患者首诊于神经科医生。2020年为患病率最高的年份,随访期间偏头痛患病率为每100名HMO会员中有1.69至2.42例患者,患病率为2.42(95%可信区间2.41 - 2.44),发病率为每100名有患偏头痛风险的患者年发病率为0.032至1.72例。高血压(21.3%)、心律失常(4.1%)和结构性心脏病(3.4%)是最常见的心血管疾病。2018年门诊咨询的年平均次数为每位患者1.43次,到2022年降至0.68次。急性发作最常用的治疗方法是单药治疗的非甾体抗炎药(NSAIDs)(范围37 - 42%)、镇痛药联合使用(范围14 - 35%)和皮质类固醇(范围10 - 15%)。在首次用药记录中,4%的患者使用了曲坦类药物,最多时达到16%的患者使用。在预防性治疗中,β受体阻滞剂(24 - 49%)和抗癫痫药(29 - 41%)最为常见。

结论

根据卫生电子数据库,哥伦比亚偏头痛的患病率低于该国此前研究报告的患病率。偏头痛急性和预防性治疗模式遵循不同指南的建议。心血管疾病与偏头痛的管理相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52c/11667797/d996ffc0f892/10194_2024_1918_Figa_HTML.jpg

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