Article

Individuals with headache after traumatic brain injury (TBI) receive
care in a wide variety of clinical locations by physicians trained in multiple
specialties. OBJECTIVE: To understand current practice patterns and perceptions
of treatment issues among clinicians managing headache after TBI. DESIGN:
National survey of current clinical practice using a 20-item questionnaire
developed by the authors. PARTICIPANTS: Survey respondents were members of the
Central Nervous System Council list survey of the American Academy of Physical
Medicine and Rehabilitation (N = 1782) and the American Headache Society
membership (N = 1260). METHODS: The survey was sent electronically to potential
participants and was followed by 2 biweekly reminders. The survey queried the
physicians' clinical setting; their use of headache classification systems,
headache diaries, checklists, and diagnostic procedures; the pharmacologic and
nonpharmacologic treatments prescribed; and headache chronicity and associated
symptoms and disorders among their patients with TBI. RESULTS: Completed surveys
were received from 193 respondents. The use of standardized classification
systems and checklists was commonly reported. Respondents used nonpharmacologic
and pharmacologic treatment approaches with similar frequency and modest
perceived success rates. A high frequency of headache-associated new sleep and
mood disorders was reported. When response differences occurred between practice
settings, they reflected a focus on headache diagnosis, classification, and
pharmacologic treatment among neurology and specialty headache clinics, whereas a
nonpharmacologic approach to management among TBI specialty and general
rehabilitation clinicians was more commonly reported. CONCLUSION: Management
strategies for treating headache after TBI vary widely among general and
specialty clinical practices. This suggests that additional research is needed
that would lead to an increase in the use of established headache classification
and the development of standardized management approaches so that all
practitioners who care for patients after TBI can provide consistent effective care.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS