Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_ED19C351854F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey.
Journal
BMC neurology
Author(s)
Ryvlin P., Skorobogatykh K., Negro A., Sanchez-De La Rosa R., Israel-Willner H., Sundal C., MacGregor E.A., Guerrero A.L.
ISSN
1471-2377 (Electronic)
ISSN-L
1471-2377
Publication state
Published
Issued date
04/01/2021
Peer-reviewed
Oui
Volume
21
Number
1
Pages
1
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Migraine is a prevalent and disabling headache disorder that affects more than 1.04 billion individuals world-wide. It can result in reduction in quality of life, increased disability, and high socio-economic burden. Nevertheless, and despite the availability of evidence-based national and international guidelines, the management of migraine patients often remains suboptimal, especially for chronic migraine (CM) patients.
My-LIFE anamnesis project surveyed 201 General practitioners (GPs) from 5 European countries (France, Germany, Italy, Spain, and the UK) with the aim of understanding chronic migraine (CM) patients' management in the primary care setting.
In our survey, GPs diagnosed episodic migraine (EM) more often than CM (87% vs 61%, p < 0.001). We found that many CM patients were not properly managed or referred to specialists, in contrast to guidelines recommendations. The main tools used by primary-care physicians included clinical interview, anamnesis guide, and patient diary. Tools used at the first visit differed from those used at follow-up visits. Up to 82% of GPs reported being responsible for management of patients diagnosed with disabling or CM and did not refer them to a specialist. Even when the GP had reported referring CM patients to a specialist, 97% of them were responsible for their follow-up. Moreover, the treatment prescribed, both acute and preventive, was not in accordance with local and international recommendations. GPs reported that they evaluated the efficacy of the treatment prescribed mainly through patient perception, and the frequency of follow-up visits was not clearly established in the primary care setting. These results suggest that CM is underdiagnosed and undertreated; thereby its management is suboptimal in the primary care.
There is a need of guidance in the primary care setting to both leverage the management of CM patients and earlier referral to specialists, when appropriate.
Keywords
Anamnesis, Chronic migraine, Diagnosis, Guidance, Headache disorders, Management, Primary care, Prophylaxis, Referral
Pubmed
Web of science
Open Access
Yes
Create date
11/01/2021 14:14
Last modification date
12/06/2021 6:13
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