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Estudo da enxaqueca em idade pediátrica nos cuidados de saúde primários da região Centro de Portugal
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Advisor(s)
Abstract(s)
Introdução: A enxaqueca é uma cefaleia primária comum, que pode ter início em idade pediátrica. Não existem dados concretos nos cuidados de saúde primários (CSP) em Portugal. Foi objetivo deste estudo caracterizar uma população pediátrica com diagnóstico de enxaqueca em seguimento nos CSP da região Centro de Portugal, abordando aspetos demográficos, epidemiológicos e clínicos.
Métodos: No primeiro trimestre de 2018, a partir de dados retrospetivos colhidos exclusivamente em ambiente de CSP, selecionámos uma amostra de indivíduos em idade pediátrica de 11 unidades de saúde, com diagnóstico de enxaqueca codificado nos problemas ativos do sistema informático. Foram recrutados sequencialmente e entrevistados de acordo com um guião pré-definido, baseado nos critérios da Classificação Internacional de Cefaleias. Realizámos a análise estatística descritiva das variáveis recolhidas.
Resultados: Recrutámos 117 indivíduos e, após entrevista, apenas 72 foram incluídos. Estimámos uma prevalência de enxaqueca pediátrica de 0,35% nessas unidades, afetando predominantemente adolescentes do sexo feminino. O intervalo de tempo decorrido entre o início dos sintomas e o diagnóstico teve uma mediana de 1,3 anos (0-3 anos). Confirmámos que faziam terapêutica profilática 22,2% dos casos e terapêutica abortiva de crise 97,2% deles, sendo as classes mais utilizadas os analgésicos simples (65,7%) e anti-inflamatórios não esteróides (50,0%). Apenas uma minoria utilizava triptanos (2,9%). A automedicação foi reportada em 12,5% dos casos. Recorriam à terapêutica não farmacológica 66,7% dos doentes.
Discussão: O diagnóstico e prevalência estimada de enxaqueca pediátrica nos CSP ficaram aquém dos valores descritos na literatura. O tratamento implementado nas crises é adequado, mas a utilização de terapêutica não farmacológica e profilática poderão ser otimizadas, nesta população particular. Salvaguarda-se, no entanto, que este foi um estudo preliminar de natureza retrospetiva realizado numa população de uma zona geográfica específica do país, carecendo naturalmente de confirmação posterior.
Introduction: Migraine is a common primary headache, which can begin in the pediatric age. There are no concrete data on primary health care (PHC) in Portugal. This study aimed to characterize a pediatric population with migraine followed at PHC in the central region of Portugal, addressing demographic, epidemiological and clinical aspects. Methods: In the first trimester of 2018, from retrospective data collected exclusively in a PHC environment, we selected a sample of pediatric individuals of 11 health units with a diagnosis of migraine encoded in the active problems of units’ informatics system. They were sequentially recruited and interviewed according to a pre-defined guide, based on the International Classification of Headache Disorders criteria. A descriptive analysis of collected variables was conducted. Results: We recruited 117 individuals and, after interview, only 72 were included. We estimated a prevalence of pediatric migraine of 0.35% in these units, affecting predominantly female adolescents. The time elapsed between the onset of symptoms and the diagnosis had a median of 1.3 years (0-3 years). We confimed that prophylactic therapy was used by 22.2% of cases and abortive therapy by 97.2%, with the most commonly used classes being simple analgesics (65.7%) and non-steroidal anti-inflmmatory drugs (50.0%). A minority used triptans (2.9%). Self-medication was reported in 12.5% of cases; 66.7% referred the usage of non-pharmacological therapy. Discussion: The diagnosis and estimated prevalence of pediatric migraine in PHC units fell short of the values described in the literature. The abortive treatment was considered adequate, but the use of non-pharmacological and prophylactic therapies may be optimized in this particular population. However, this was a preliminary study of a retrospective nature carried out in a population of a specific geographic area of the country, naturally requiring further confimation.
Introduction: Migraine is a common primary headache, which can begin in the pediatric age. There are no concrete data on primary health care (PHC) in Portugal. This study aimed to characterize a pediatric population with migraine followed at PHC in the central region of Portugal, addressing demographic, epidemiological and clinical aspects. Methods: In the first trimester of 2018, from retrospective data collected exclusively in a PHC environment, we selected a sample of pediatric individuals of 11 health units with a diagnosis of migraine encoded in the active problems of units’ informatics system. They were sequentially recruited and interviewed according to a pre-defined guide, based on the International Classification of Headache Disorders criteria. A descriptive analysis of collected variables was conducted. Results: We recruited 117 individuals and, after interview, only 72 were included. We estimated a prevalence of pediatric migraine of 0.35% in these units, affecting predominantly female adolescents. The time elapsed between the onset of symptoms and the diagnosis had a median of 1.3 years (0-3 years). We confimed that prophylactic therapy was used by 22.2% of cases and abortive therapy by 97.2%, with the most commonly used classes being simple analgesics (65.7%) and non-steroidal anti-inflmmatory drugs (50.0%). A minority used triptans (2.9%). Self-medication was reported in 12.5% of cases; 66.7% referred the usage of non-pharmacological therapy. Discussion: The diagnosis and estimated prevalence of pediatric migraine in PHC units fell short of the values described in the literature. The abortive treatment was considered adequate, but the use of non-pharmacological and prophylactic therapies may be optimized in this particular population. However, this was a preliminary study of a retrospective nature carried out in a population of a specific geographic area of the country, naturally requiring further confimation.
Description
Keywords
Child Headache Migrane disorders Primary Health Care
Citation
Lopes Freitas, R. et al. Estudo da enxaqueca em idade pediátrica nos cuidados de saúde primários da região Centro de Portugal. Sinapse. 2020;20(1):9-16. DOI: 10.46531/sinapse/2020/AO/200007/2020
Publisher
Sociedade Portuguesa de Neurologia