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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Communicating the right therapy for the right patient at the right time: acute therapy.
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Communicating the right therapy for the right patient at the right time: acute therapy.

机译：在正确的时间为正确的患者传达正确的疗法：急性疗法。

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OBJECTIVE: Review of problems arising from communication difficulties in headache practice. METHODS: Literature review and assessment of practice experience. BACKGROUND: Advances in understanding of the pathophysiology of migraine and the availability of specific acute therapies have given migraine sufferers access to effective treatment and physicians a wide array of therapeutic alternatives. There remains uncertainty about the best drug group for any given patient and about which triptan to use when and in which formulation; about patient preference and satisfaction; about interpretations of pivotal trials and meta-analyses; and about the relevance of large group efficacy and safety data to the individual patient. The clinician may be daunted by the array of triptans with choices of dosage and multiple formulations and will likely learn how to use two or three of them at most, as in depression and hypertension. In the context of the wide array of choices and the complexities of assessing responses and patient preferences, this paper attempts to provide a framework for incorporating the evidence with clinical experience and for communicating these concepts effectively. Benefits, HARMS AND COSTS: None. RESULTS AND CONCLUSION: Even when an appropriate recommendation is determined, therapy may fail unless the doctor patient relationship permits open communication, time for questions and answers and time for instruction on how to use a given medication, and its probable effects. Translating evidence into patient-friendly language is a skill as necessary as that of making the clinical decision itself. Tools are available that can support this effort and aid in creating an environment of "partnership".
机译：目的：回顾头痛练习中因沟通困难而引起的问题。方法：文献复习和评估实践经验。背景：对偏头痛的病理生理学的了解以及特定急性疗法的可利用性，使偏头痛患者获得了有效的治疗方法，医生们也获得了广泛的治疗选择。对于任何给定的患者而言，最佳药物类别以及何时何地使用哪种曲普坦仍存在不确定性。关于患者的偏好和满意度;关于关键性试验和荟萃分析的解释;以及有关大型团体疗效​​和安全性数据与个别患者的相关性。临床医生可能会对多种曲坦类药物感到震惊，他们需要选择剂量和多种配方，并且可能会学会如何最多使用两种或三种，如在抑郁症和高血压中。在各种各样的选择以及评估反应和患者偏好的复杂性的背景下，本文试图提供一个将证据与临床经验相结合并有效传达这些概念的框架。收益，危害和成本：无。结果与结论：即使确定了适当的建议，除非医生与患者之间的关系允许公开沟通，提出问题和答案的时间以及有关如何使用给定药物及其可能效果的指导时间，否则治疗可能会失败。将证据转换为对患者友好的语言是一项与做出临床决策本身相同的必要技能。提供了可以支持此工作并有助于创建“伙伴关系”环境的工具。

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