PMID- 15184590
OWN - NLM
STAT- MEDLINE
DCOM- 20041220
LR  - 20190514
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Linking)
VI  - 62
IP  - 11
DP  - 2004 Jun 8
TI  - Migraine practice patterns among neurologists.
PG  - 1926-31
AB  - OBJECTIVE: To assess the attitudes, knowledge, and practice patterns of US 
      neurologists regarding migraine management relative to the US Headache Consortium 
      Guidelines (the Guidelines). METHODS: Two samples of 600 neurologists each were 
      selected from the American Academy of Neurology membership database. The first 
      group received a Migraine Attitudes, Knowledge, and Practice Patterns (MKAPP) 
      Survey. The second group received a Clinical Vignette (CV) Survey, presenting two 
      patient histories and correspondent questions. RESULTS: The MKAPP Survey showed 
      that most neurologists felt that migraine was primarily a disease of the brain 
      with a well-established neurobiological basis (69%) and an important part of 
      their practice (60%). Most (53%) indicated that they routinely used neuroimaging 
      in evaluating severe headache, an approach not recommended by the Guidelines. 
      Most favored acute treatment limits, but 36% did not agree with the Guidelines 
      that acute treatment should be limited to 2 or 3 days/week. In the CV Survey, for 
      vignette 1, most (91%) correctly diagnosed migraine, 31% requested neuroimaging 
      in the absence of indications, 64% appropriately recommended a triptan, and 45% 
      recommended a preventive medication in the absence of indications. For vignette 
      2, 78% diagnosed migraine, 71% appropriately ordered neuroimaging, 80% 
      appropriately recommended a preventive medication, and 38% prescribed a triptan 
      in face of clear contraindication. CONCLUSIONS: Educational initiatives aiming to 
      increase the awareness of the Guidelines among neurologists should highlight the 
      full range of migraine symptoms that support the diagnosis, appropriate use of 
      neuroimaging, indications for preventive treatments, issues of triptan 
      cardiovascular safety, and preventing rebound headaches.
FAU - Lipton, R B
AU  - Lipton RB
AD  - Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, 
      USA. Rlipton@aecom.yu.edu
FAU - Bigal, M E
AU  - Bigal ME
FAU - Rush, S R
AU  - Rush SR
FAU - Yenkosky, J P
AU  - Yenkosky JP
FAU - Liberman, J N
AU  - Liberman JN
FAU - Bartleson, J D
AU  - Bartleson JD
FAU - Silberstein, S D
AU  - Silberstein SD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
SB  - IM
MH  - Adult
MH  - Data Collection
MH  - Drug Resistance
MH  - Female
MH  - Headache Disorders/drug therapy
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Hypercholesterolemia/complications
MH  - Hypertension/complications
MH  - Male
MH  - Middle Aged
MH  - Migraine Disorders/*drug therapy
MH  - Migraine without Aura/drug therapy
MH  - Neurology/*statistics & numerical data
MH  - Practice Guidelines as Topic
MH  - *Practice Patterns, Physicians'/statistics & numerical data
MH  - United States
EDAT- 2004/06/09 05:00
MHDA- 2004/12/21 09:00
CRDT- 2004/06/09 05:00
PHST- 2004/06/09 05:00 [pubmed]
PHST- 2004/12/21 09:00 [medline]
PHST- 2004/06/09 05:00 [entrez]
AID - 10.1212/wnl.62.11.1926 [doi]
PST - ppublish
SO  - Neurology. 2004 Jun 8;62(11):1926-31. doi: 10.1212/wnl.62.11.1926.