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 psycholog...

研究目的 深化对全科医生（General Practitioners, GPs）关于头痛患者管理及直接接入磁共振成像（magnetic resonance imaging, MRI）扫描使用情况的认知与实践体验的理解，并观察具有专科兴趣的全科医生（GP with a Special Interest, GPwSI）为其他全科医生开设的教育课程的实施效果。
研究设计 本研究采用质性研究设计，通过半结构化访谈开展数据收集，并运用主题分析法进行数据分析。一位专攻头痛领域的GPwSI前往各基层医疗机构，开展关于头痛药物治疗、诊断与临床管理的专题讲座。
研究场景 英国伦敦南部的16家基层家庭医疗诊所。
研究参与者 共纳入20名全科医生。
研究结果 并非所有全科医生均知晓直接接入MRI扫描的服务可及性，但所有受访者均承认曾通过转诊或直接扫描的方式，缓解患者对头痛症状的担忧。扫描结果正常有助于消除患者与全科医生的诊疗不确定性，并推动开展预防性治疗相关的讨论。然而，伴随心理因素的头痛患者……