Furlong S, Pryse-Phillips W, Crowley M, Turner C J
Memorial University of Newfoundland, St John's, Canada.
Headache. 1996 Oct;36(9):542-6. doi: 10.1046/j.1526-4610.1996.3609542.x.
To assess the impact of sumatriptan in clinical practice, we undertook a retrospective analysis of the government of Newfoundland and Labrador's prescription drug program data base for 35 consecutive patients prescribed sumatriptan. The number of doses of all drugs prescribed ranged from 121 to 18,874 on from 4 to 357 prescriptions per patient over 1 to 19 months. The mean number of doses of analgesic drugs prescribed before sumatriptan therapy was 56 per month and after initiation of sumatriptan was 46 per month. The prescribing of multiple analgesics was common; 79% received three or more different analgesics. Twenty-two (63%) patients were prescribed medications indicated for the prophylaxis of migraine concomitantly with drugs indicated for symptomatic treatment. Twenty-four (69%) patients were prescribed medication capable of inducing migraine. We conclude that sumatriptan did not have a major impact on the outcomes of these patients judged by their use of analgesics. The simplest explanation is that many of the patients were suffering from analgesic-induced headache rather than migraine. In addition, we conclude that there were deficiencies in prescribing practices including numbers, quantities, and choice of analgesics; the use of analgesics concomitantly with drugs indicated for migraine prophylaxis; and the use of drugs capable of inducing migraine. Further research is required to validate these findings.
为评估舒马曲坦在临床实践中的影响，我们对纽芬兰与拉布拉多省政府处方药数据库进行了回顾性分析，纳入了连续35例开具舒马曲坦的患者。每位患者在1至19个月内所开所有药物的剂量数在121至18874剂之间，处方数在4至357张之间。舒马曲坦治疗前开具的镇痛药平均每月剂量为56剂，开始使用舒马曲坦后为每月46剂。同时开具多种镇痛药的情况很常见；79%的患者接受了三种或更多不同的镇痛药。22例（63%）患者在开具用于偏头痛症状治疗药物的同时，还开具了用于偏头痛预防的药物。24例（69%）患者开具了可诱发偏头痛的药物。我们得出结论，从这些患者使用镇痛药的情况判断，舒马曲坦对其治疗结果没有重大影响。最简单的解释是，许多患者患有镇痛药诱发的头痛而非偏头痛。此外，我们得出结论，在处方实践中存在不足，包括镇痛药的数量、剂量和选择；在开具用于偏头痛预防药物的同时使用镇痛药；以及使用可诱发偏头痛的药物。需要进一步研究来验证这些发现。
