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 为深入了解全科医生（General Practitioners，GPs）对头痛患者管理及直接预约磁共振成像（magnetic resonance imaging，MRI）检查使用情况的看法与实践经验，并观察具备头痛专科兴趣的全科医生（GP with a Special Interest，GPwSI）为其他全科医生开展的教育课程的效果。
研究设计 采用半结构化访谈（semi-structured interviews）的质性研究，通过主题分析法（thematic analysis）进行数据分析。一名具备头痛专科兴趣的全科医生前往各基层医疗诊所开展关于头痛药物治疗、诊断与管理的专题讲座。
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 20名全科医生。
研究结果 并非所有全科医生都知晓直接预约MRI检查的渠道，但所有受访者均表示曾通过转诊或直接检查来缓解患者对头痛的担忧。正常的影像学检查结果可帮助医患双方消除诊疗不确定性，并推动后续开展预防性治疗的讨论。然而，存在心理问题或重度头痛症状的患者未必能通过此类检查获得安心。全科医生反馈称难以解读影像学报告，尤其是偶然发现的异常征象。参与过该教育讲座的全科医生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 增加影像学检查可及性、加强头痛管理相关培训、兼顾躯体与心理症状的诊疗，以及实现影像学报告标准化，或可在未来提升全科医生对直接预约MRI检查的应用水平。