从医学专家角度看希腊偏头痛管理中未满足的需求：德尔菲共识
Unmet needs in the management of migraine in Greece from the perspective of medical experts: a Delphi consensus.
作者信息
Kourlaba Georgia, Vikelis Michail, Karapanayiotides Theodoros, Solakidi Argyro, Trafalis Dimitrios, Lioliou Katerina, Andriopoulos Panagiotis, Panagiotou Aspasia, Mitsikostas Dimos-Dimitrios
机构信息
Department of Nursing, Faculty of Health Sciences, University of the Peloponnese, Tripoli, Greece.
Headache Clinic, Mediterraneo Hospital, Glyfada, Greece.
出版信息
Front Neurol. 2025 Feb 12;16:1556808. doi: 10.3389/fneur.2025.1556808. eCollection 2025.
INTRODUCTION
Migraine is a chronic, debilitating neurological disorder affecting billions worldwide. While not life-threatening, migraine patients experience significant unmet needs in diagnosis and management. Addressing these challenges could result in improvement of patient outcomes and reduction of the socioeconomic burden migraine imposes on individuals, healthcare system and the society.
OBJECTIVE
This survey aimed to capture in Greece the perspective of medical experts (neurologists) specializing in migraine management regarding the socioeconomic burden of migraine and the unmet needs in diagnosis and treatment.
METHODS
An online Delphi-based survey was conducted with 13 neurologists, experts in migraine. The survey consisted of 55 statements derived from literature research, regarding the burden of disease, diagnosis, treatment and unmet needs. Participants' level of agreement for each statement was measured through a 5-point Likert scale ("Strongly Agree," "Agree," "Neither Agree nor Disagree," "Disagree" and "Strongly Disagree"). Three rounds of voting were conducted to achieve consensus. The consensus threshold was set at 70% of responses, focusing on "Strongly Agree"/ "Agree" or "Disagree"/ "Strongly Disagree."
RESULTS
Most experts agreed on statements emphasizing on financial and social impact of the disease and its epidemiology. However, consensus was not reached on statements concerning patient preferences for treatment administration, treatment adherence, opioid use, and frequency of visits to neurologists. Consensus was reached on the need for better healthcare professional training and the development of effective, safe treatments.
CONCLUSION
This survey highlighted the challenges of prompt diagnosis and effective management of migraine. Addressing these needs requires patient-centered approaches, enhanced healthcare-provider training, tailored therapeutic interventions, and advanced communication platforms.
引言
偏头痛是一种慢性、使人衰弱的神经系统疾病，全球数十亿人受其影响。虽然不会危及生命，但偏头痛患者在诊断和管理方面存在大量未满足的需求。应对这些挑战可能会改善患者的治疗效果，并减轻偏头痛给个人、医疗系统和社会带来的社会经济负担。
目的
本次调查旨在了解希腊专门从事偏头痛管理的医学专家（神经科医生）对偏头痛社会经济负担以及诊断和治疗方面未满足需求的看法。
方法
对13名偏头痛专家神经科医生进行了基于德尔菲法的在线调查。该调查由55条源自文献研究的陈述组成，内容涉及疾病负担、诊断、治疗和未满足的需求。通过5点李克特量表（“强烈同意”、“同意”、“既不同意也不反对”、“不同意”和“强烈反对”）来衡量参与者对每条陈述的同意程度。进行了三轮投票以达成共识。共识阈值设定为70%的回复，重点关注“强烈同意”/“同意”或“不同意”/“强烈反对”。
结果
大多数专家对强调该疾病的经济和社会影响及其流行病学的陈述表示同意。然而，在关于患者对治疗给药方式的偏好、治疗依从性、阿片类药物使用以及看神经科医生的频率等陈述上未达成共识。在需要更好的医疗专业培训以及开发有效、安全的治疗方法方面达成了共识。
结论
本次调查突出了偏头痛快速诊断和有效管理的挑战。满足这些需求需要以患者为中心的方法、加强医疗服务提供者培训、量身定制的治疗干预措施以及先进的沟通平台。
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