Migraine in primary healthcare
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Es izvēlējos šo tēmu savam darbam, jo pēc 4. un 5. kursa, strādājot primārajā veselības aprūpē par vietējo ārstu, es atklāju, ka migrēna ir ļoti plaši izplatīta pacientu vidū. Sapratu, ka atslēga, lai efektīvi palīdzētu šiem pacientiem savā turpmākajā praksē, ir iegūt labu pārskatu par migrēnu kopumā.
Mērķi: Šī darba mērķis bija noskaidrot migrēnas nozīmīgumu, kā arī veicinošos un predisponējošos faktorus migrēnas rašanās gadījumā primārās veselības aprūpes pacientiem un pilnveidot uz pierādījumiem balstītu pieeju viņu diagnozei, diferenciāldiagnostikai un efektīviem ārstēšanas protokoliem akūtā un hroniskā fāzē. Kā arī tika iekļauts migrēnas ekonomiskais slogs, lai dotu priekšstatu par kopējām izmaksām un nastu, ko migrēna rada ekonomikai. Literatūras apskata mērķis bija izpētīt atbilstošos pētījumus dažādās valstīs, lai iegūtu pārskatu par slimību.
Metodoloģija: Retrospektīvs literatūras apskats tika veikts starp recenzētiem pārskatiem, kas publicēti PubMed un publicētās starptautiskās un vietējās vadlīnijās no 2015. gada līdz 2020. gadam. Kā arī migrēnas un galvassāpju vēsturiskās dimensijas tika apkopotas no viena pētījuma un Svētās Bībeles. Literatūras apskata materiāls tika savākts 2020. gada februārī.
Secinājumi: Migrēna ir viena no visizplatītākajiem traucējumiem, ar kuru primārās veselības aprūpes ārsts saskarās savā praksē. Tā ir vairāku notikumu kaskāde, kas attīstās stundās vai dienās. Tiek lēsts, ka gandrīz 30 % akūtu apmeklējumu notiek migrēnas dēļ un 1/6 iedzīvotāju ir migrēna. Migrēna rada smagu ekonomisku un ar veselību saistītu slogu pacientam, darba devējam un visai veselības aprūpes sistēmai. Lielākā daļa migrēnas pacientu var un tiek ārstēti primārās veselības aprūpes iestādēs. Ir ārkārtīgi svarīgi, lai katram primārās veselības aprūpes ārstam būtu labas zināšanas migrēnas traucējumu diagnostikā, patofizioloģijā, ārstēšanā, difenciāldiagnostikā un, pats galvenais, jāzina, kad pacientam nepieciešama speciālista konsultācija vai papildu izmeklēšana. Stūrakmens, lai samazinātu slimības slogu un nodrošinātu pacientiem labu dzīves kvalitāti, ir pareizi ārstēt un diagnosticēt migrēnu un tās apakštipus.
Background: I choose this topic for my thesis because I found out working in primary health care after my 4th and 5th year studies as a locum doctor that migraine is very abundant in the patient mass. I realized that the key to effectively help these patients in my future practice was to get a good overview of migraine as a whole. Aims and objectives: This study aimed to find the significance of migraine as well as contributing and predisposing factors for migraine occurrence amongst the patients in primary health care and to increase evidence-based approaches for their diagnosis, differential diagnosis and effective treatment protocols in acute and chronic phases. Also, the economic burden of migraine was included to give perspective of the total costs and burden that migraine causes to the economy. Aim of the literature review was to explore the corresponding studies in different countries to get an overview of the disease. Also to find that comparing several different approaches if there exists any differences between them. Participants and methods: A retrospective literature review was carried out among peer reviewed reviews published from 2015 to 2020 in PubMed and published international and local guidelines. Also, historical dimensions of headache and migraine were gathered from one study and The Holy Bible. The study material reviewed was collected in February 2020. Conclusions: Migraine is one of the most abundant disorders a primary health care physician will encounter in his practice. It is a cascade on multiple events that evolve in hours or days It is estimated that nearly 30% of acute visits are due migraine and 1/6 of the population have migraine. Migraine causes severe economic and health related burden to the patient, employer and the whole health care system. Most of the migraine patients can be and are treated in primary health care settings. It is crucial that every primary health care physician has a good knowledge in migraine disorder diagnostics, pathophysiology, treatment, differential diagnosis and most of all to know when the patient needs specialist consultation or further investigations. The corner stone of lowering the burden of the disease and to give patients good quality of life is to treat and diagnose migraine and its subtypes correctly.
Background: I choose this topic for my thesis because I found out working in primary health care after my 4th and 5th year studies as a locum doctor that migraine is very abundant in the patient mass. I realized that the key to effectively help these patients in my future practice was to get a good overview of migraine as a whole. Aims and objectives: This study aimed to find the significance of migraine as well as contributing and predisposing factors for migraine occurrence amongst the patients in primary health care and to increase evidence-based approaches for their diagnosis, differential diagnosis and effective treatment protocols in acute and chronic phases. Also, the economic burden of migraine was included to give perspective of the total costs and burden that migraine causes to the economy. Aim of the literature review was to explore the corresponding studies in different countries to get an overview of the disease. Also to find that comparing several different approaches if there exists any differences between them. Participants and methods: A retrospective literature review was carried out among peer reviewed reviews published from 2015 to 2020 in PubMed and published international and local guidelines. Also, historical dimensions of headache and migraine were gathered from one study and The Holy Bible. The study material reviewed was collected in February 2020. Conclusions: Migraine is one of the most abundant disorders a primary health care physician will encounter in his practice. It is a cascade on multiple events that evolve in hours or days It is estimated that nearly 30% of acute visits are due migraine and 1/6 of the population have migraine. Migraine causes severe economic and health related burden to the patient, employer and the whole health care system. Most of the migraine patients can be and are treated in primary health care settings. It is crucial that every primary health care physician has a good knowledge in migraine disorder diagnostics, pathophysiology, treatment, differential diagnosis and most of all to know when the patient needs specialist consultation or further investigations. The corner stone of lowering the burden of the disease and to give patients good quality of life is to treat and diagnose migraine and its subtypes correctly.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Primāras galvassāpes, migrēna, NSPIL, triptāni, ģimenes medicīna, primārā veselības aprūpe, Primary headache, migraine, NSAID, triptan, family medicine, primary health care