BackgroundMigraine diagnosis is based on clinical aspects and is dependent on the experience of the attending physician. This study aimed to describe the patients journey profile until they start their experience in a tertiary headache center.MethodsIn a cross-sectional study, medical charts from migraine patients were reviewed to describe which treatments, procedures and follow-up strategies are performed until the first appointment with a headache specialist. Patients from both sexes, ≥18 years old, which came to their first visit from March to July 2017 were included. Sociodemographic information, headache characteristics, diagnostic methods previously used, clinical history, family history and the treatments previously used were assessed in the first appointment with a specialist. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were also applied. Descriptive analyses were performed to describe the sample profile and statistical tests were used to evaluate factors associated with the type of migraine (chronic or episodic).ResultsThe sample consisted of 465 patients. On average, the pain started 17.1 (SD = 11.4) years before the first appointment with a headache specialist. Most of patients were classified as having chronic migraine (51.7%), with an average frequency of 15.5 (SD = 9.9) days per month. Regarding patients’ journey until a specialist, most patients were submitted to laboratory tests (74.0%), cranial tomography (66.8%) and magnetic resonance imaging (66.8%) as diagnostic methods, and preventive drugs (70.2%) and acupuncture (61.0%) as treatments. After stratification by migraine type as episodic or chronic, patients with chronic migraine were submitted to more magnetic resonance imaging test, acupuncture, psychotherapy, used preventive drugs, and reported to have used topiramate without beneficial effects.ConclusionsBrazilian patients with migraine experiment a long journey until getting to a headache specialist and are submitted to a great number of unnecessary exams, especially those with chronic migraine.

中文翻译：

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偏头痛患者到三级头痛中心的旅程：一项观察性研究

背景偏头痛的诊断基于临床方面，取决于主治医师的经验。本研究旨在描述患者在三级头痛中心开始体验之前的旅程概况。 方法 在一项横断面研究中，审查了偏头痛患者的病历，以描述在第一次头痛之前进行了哪些治疗、程序和随访策略与头痛专家预约。纳入 2017 年 3 月至 7 月首次就诊的年龄≥18 岁的男女患者。社会人口学信息、头痛特征、以前使用的诊断方法、临床病史、家族史和以前使用的治疗方法在第一次与专科医生会面时进行评估。还应用了患者健康问卷 9 和一般焦虑症 7。进行描述性分析以描述样本概况，并使用统计检验来评估与偏头痛类型（慢性或发作性）相关的因素。结果样本包括 465 名患者。平均而言，在第一次就诊头痛专家前 17.1 (SD = 11.4) 年开始疼痛。大多数患者被归类为慢性偏头痛 (51.7%)，平均频率为每月 15.5 (SD = 9.9) 天。关于患者就医的旅程，大多数患者接受了实验室检查 (74.0%)、颅脑断层扫描 (66.8%) 和磁共振成像 (66.8%) 作为诊断方法，以及预防药物 (70.2%) 和针灸 (61.0%) ) 作为治疗。