Duration Of Treatment Use Research Articles

ALTHOUGH PHARMACOLOGICAL TREATMENT IS SUCCESSFUL IN SMOKING CESSATION, WHAT ARE THE FACTORS THAT REDUCE PATIENTS COMPLIANCE TO DRUGS

Objectives: Pharmacological treatment has been shown to increase success in moderate and high nicotine addicts.Although the success of quitting is even higher with three months of regular treatment, the rates of using the treatment are low.In this study, although it was emphasized that patients should use 3 months of regular treatment, the reasons for not using pharmacological treatment were investigated. Methods: One year after the initiation of smoking cessation treatment, the patients were called at least 3 times, and a questionnaire was conducted with the verbal consent of 281 patients. Results: A total of 277 (%70.1) of 395 cases included in the study were male and their mean age was 41.35 ± 11.6 (18--79) years.When the duration of treatment use of 281 cases was questioned, it was seen that only 108 (38.4%) completed the treatment. Some patients not used the drugs due to side effects of the drugs (30.6%), some patients (20.2%) thought that the medication will not be effective, some patients (19.7%) thought that they weren't ready to quit, some patients (16.2%) thought that they quit smoking already. Considering the rate of quitting after one year, it was found that 33.8% of them quit smoking. Conclusion: Although studies have shown that 3 months of regular pharmacological treatment in smoking cessation treatment increases the success of quitting and decreases relapse, it was found that 61.6% of the patients did not use the treatment for three month.

Real world preventative drug management of migraine among Spanish neurologists

BackgroundMany different preventatives have showed efficacy in the treatment of migraine. National guidelines differ in their recommendations and patients’ characteristics are usually taken into account in their selection. In Spain, real life use of preventive therapies seems to be heterogeneous. We aimed to evaluate differences in clinical practice and adherence to national guidelines among Spanish neurologists.MethodsObservational descriptive study. A survey was conducted among neurologists ascribed to the Spanish Society of Neurology. Participants were differentiated in accordance with their dedication to headache disorders. We analysed socio-demographic parameters and evaluated 43 questions considering migraine management as well as therapeutic choices regarding migraine sub-types and finally, neurologists’ personal perception.ResultsOne hundred fifty-five neurologists participated from 17 different regions, 43.4% of them female and 53.3% under 40 years of age. 34.9% confirmed headache disorders as their main interest.The first choice for preventive therapy in chronic migraine among participants was topiramate (57%) followed by amytriptiline (17.9%) and beta-blockers (14.6%). However in episodic migraine, the preferred options were beta-blockers (47.7%), topiramate (21.5%) and amytriptiline (13.4%). Regarding perceived efficacy, topiramate was considered the best option in chronic migraine (42.7%) followed by onabotulinumtoxinA (25.5%) and amitryptiline (22.4%). Where episodic migraine was concerned, surveyed neurologists perceived topiramate (43.7%) and beta-blockers (30.3%) as the best options. When we evaluated the duration of treatment use with a view to adequate therapeutic response, 43.5% of neurologists preferred 3 months duration and 39.5% were in favour of 6 months duration in episodic migraine. However, considering the preferred duration of treatment use in chronic migraine, 20.4% recommended 3 months, 42.1% preferred 6 months and 12.5% and 22.4% opted for 9 and 12 months respectively. When considering onabotulinumtoxinA therapy, the number of prior therapeutic failures was zero in 7.2% of neurologists, one in 5.9%, two in 44.1%, three in 30.9% and four or more in 11.9%. Following an initial treatment failure with onabotulinumtoxinA, 49% of subjects decided against a second treatment. The number of OnabotA procedures before considering it as ineffective was two in 18.9% of neurologists, three in 70.8% and four in 10.4%.ConclusionsThe initial management of migraine among Spanish Neurologists is in line with most guidelines, where first choice preventative drugs are concerned. The Management of episodic migraine differed from chronic migraine, both in terms of neurologist preference and in their perceived efficacy.