Data from: Primary care management of headaches and how direct-access MRI fits: a qualitative study of UK general practitioners’ views

Objectives To develop a better understanding of General Practitioners’ (GPs) views and experiences of the management of patients with headaches and use of direct access magnetic resonance imaging (MRI) scans, and observe outcomes of an educational session offered by a GP with a Special Interest (GPwSI) to GPs.
Design A qualitative study using semi-structured interviews, analysed using thematic analysis. A GPwSI in headaches visited practices delivering a talk on headache medication, diagnosis, and management.
Setting Sixteen (16) primary care family practices in South London, United Kingdom.
Participants Twenty (20) General Practitioners.
Results Not all GPs were aware of the availability of direct access MRI, but all acknowledged having used referral or direct-scans to manage patients’ concern about their headaches. A normal scan result helped resolve uncertainty for patient and GP, and helped management towards discussion of preventative treatment. However, patients with psychological and/or severe headache symptoms could not necessarily be reassured. GPs reported difficulty interpreting radiology reports, particularly incidental abnormalities. Those who received the educational talk gained knowledge in diagnosis and medication, improving their confidence in management.
Conclusions Increased access to imaging, training in headache management, addressing physical and psychological symptoms, and standardized reporting of scans, may improve GP use of direct access MRI in future.

研究目标 旨在深入了解全科医师（General Practitioners，GPs）对头痛患者诊疗及直接访问磁共振成像（magnetic resonance imaging，MRI）应用的看法与实践经验，并评估具有专科兴趣的全科医师（GP with a Special Interest，GPwSI）面向其他全科医师开展的教育课程的实施效果。
研究设计 本研究采用半结构化访谈的质性研究方法，运用主题分析法进行数据分析。一名头痛领域的GPwSI前往各基层医疗点开展关于头痛药物治疗、诊断与诊疗管理的专题讲座。
研究场景 英国伦敦南部的16家基层家庭医疗诊所。
研究对象 共计20名全科医师。
研究结果 并非所有全科医师都知晓直接访问MRI的可用渠道，但所有受访医师均表示曾通过转诊或直接扫描来缓解患者对头痛症状的担忧。影像学检查结果正常可帮助医师与患者消除诊疗不确定性，并推动后续预防性治疗的讨论。然而，伴有心理问题或重度头痛症状的患者往往难以获得有效安抚。全科医师还反馈解读放射学报告存在困难，尤其是遇到偶发异常征象时。参与过专题教育讲座的医师则在头痛诊断与药物治疗方面获得了更多知识，提升了诊疗管理的自信心。
研究结论 提升影像学检查可及性、加强头痛诊疗相关培训、兼顾躯体与心理症状的干预，以及标准化扫描报告流程，或可在未来改善全科医师对直接访问MRI的应用情况。