Primerjava kakovosti življenja bolnikov z migreno pred in po uvedbi bioloških zdravil : magistrsko delo

Kalač, Albina (author), Žibert, Janez (mentor), Kamenšek, Tina (comentor), Fabjan, Andrej (comentor), Mlinar, Suzana (reviewer)

Uvod: Migrena je kompleksna nevrološka motnja, ki pomembno vpliva na vsakodnevno funkcioniranje bolnikov, povzroča omejitve pri opravljanju vsakodnevnih dejavnostih in poslabšuje psihofizično počutje. Biološka zdravila predstavljajo sodobno možnost zdravljenja, saj lahko zmanjšajo pogostost migrenskih napadov, jakost bolečine in zmanjšajo funkcionalne omejitve bolnikov. V Sloveniji je na voljo malo podatkov o njihovem vplivu v vsakodnevni klinični praksi. Namen: Namen raziskave je bil oceniti učinek bioloških zdravil za zdravljenje migrene in kakovost življenja bolnikov ter njihov vpliv na število migrenskih dni, intenzivnost bolečine in uporabo analgetikov. Zastavljene so bile tri raziskovalne hipoteze: 1. Uvedba bioloških zdravil pri bolnikih z migreno pomembno zmanjša invalidnost zaradi migrene, merjene s pomočjo vprašalnika MIDAS. 2. Uvedba bioloških zdravil pri bolnikih z migreno zmanjša intenzivnost glavobola, merjeno z vizualno analogno lestvico (VAS). 3. Uvedba bioloških zdravil pri bolnikih z migreno zmanjša število migrenskih dni na mesec in uporabo analgetikov. Metode dela: Izvedena je bila retrospektivna kvantitativna analiza na vzorcu 92 bolnikov, starih med 18 in 65 let, z diagnozo migrene, ki so prejeli biološko zdravilo na Nevrološki kliniki Ljubljana. Podatki so bili zbrani na treh časovnih točkah, in sicer pred uvedbo bioloških zdravil ter po 3 in 12 mesecih terapije. Uporabljeni so bili vprašalnika MIDAS in VAS ter podatki o migrenskih dnevih in uporabi analgetikov. Statistična analiza je bila izvedena z uporabo opisne statistike ter Wilcoxonovim in Friedmanovim testom v programu SPSS. Rezultati: V raziskavo je bilo vključenih 92 bolnikov (87 % žensk) s povprečno starostjo 44,5 leta. Povprečno število migrenskih dni se je zmanjšalo iz 10 [IQR: 7–12,5] dni pred zdravljenjem na 3 [IQR: 2–5] dni po 3 mesecih in na 2 [IQR: 1,5-3] dni po 12 mesecih. Uporaba analgetikov se je zmanjšala s povprečno 12,5 [IQR: 9–19,5] tablete pred zdravljenjem na povprečno 4 [IQR: 1–6] tablete po 3 mesecih in na povprečno 2 [IQR: 2–4] tableti po 12 mesecih. Povprečna jakost bolečine se je zmanjšala z intenzivnosti 8 [IQR: 8–9] pred zdravljenjem na intenzivnost 4 [IQR: 3–6] po 3 mesecih in vztrajala pri intenzivnosti 4 [IQR: 3–5] tudi po 12 mesecih. Mediana rezultata lestvice MIDAS se je zmanjšala z 19 [IQR: 12–30] točk pred zdravljenjem na 4 [IQR: 0–7] točke po 3 mesecih in na 2 [IQR: 0–6] točki po 12 mesecih. Vse spremembe so bile statistično značilno pomembne (p < 0,005). Razprava in zaključek: Rezultati potrjujejo podatke iz literature, da biološka zdravila učinkovito zmanjšajo pogostost in intenziteto migrenskih napadov ter izboljšajo funkcionalno stanje bolnikov. Učinki so zaznavni že po 3 mesecih in so se ohranili tudi po 12 mesecih.

• Language: Slovenian
• Keywords: magistrska dela, zdravstvena nega, monoklonska protitelesa, nevrologija, preventivno zdravljenje, vloga medicinske sestre
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Ličina]
• Year: 2025
• Number of pages: 56 str., [5] str. pril.
• PID: 20.500.12556/RUL-172503
• UDC: 616-083
• COBISS.SI-ID: 248004099
• Publication date in RUL: 07.09.2025

Secondary language

• Language: English
• Title: Comparison of the quality of life of patients with migraine before and after the treatment of biological therapy : master thesis

Abstract

Introduction: Migraine is a complex neurological disorder that can significantly impacts patient’s daily functioning, limits their ability to perform routine activities and adversely affects their overall physical and mental well-being. Biological therapies represent a modern treatment option, as they can reduce the frequency of migraine attacks, pain intensity, and the functional limitations associated with migraine. In Slovenia, there is limited real-world data on their effectiveness in routine clinical practice. Aim: Objective: The aim of this study was to evaluate the impact of biological therapies on the functional status of migraine patients, as well as their effect on the number of migraine days, pain intensity, and analgesic use. The study addressed three hypotheses: 1. The introduction of biological therapies significantly reduces migraine-related disability, as measured by the MIDAS questionnaire. 2. Biological therapies reduce headache intensity, as assessed using the Visual Analog Scale (VAS). 3. Biological therapies decrease the number of monthly migraine days and the use of analgesics. Methods: A retrospective quantitative analysis was conducted on a sample of 92 patients aged 18 to 65 years with a diagnosis of migraine who received biological therapy at the Neurology Clinic in Ljubljana. Data were collected at three time points: prior to therapy initiation, and after 3 and 12 months of treatment. The MIDAS and VAS questionnaires were used, along with information on migraine days and analgesic use. Statistical analysis was carried out using descriptive statistics, the Wilcoxon signed-rank test, and the Friedman test in SPSS. Results: The study included 92 patients (87% female), with a mean age of 44.5 years. The median number of migraine days per month decreased from 10 [IQR: 7–12.5] before treatment to 3 [IQR: 2–5] after three months, and to 2 [IQR: 1.5–3] after one year. Analgesic use declined from a median of 12.5 [IQR: 9–19.5] tablets per month before treatment to 4 [IQR: 1–6] after three months and to 2 [IQR: 2–4] after one year. Median pain intensity decreased from 8 [IQR: 8–9] to 4 [IQR: 3–6] after three months and remained at 4 [IQR: 3–5] after one year. The median MIDAS score decreased from 19 [IQR: 12–30] before treatment to 4 [IQR: 0–7] after three months, and to 2 [IQR: 0–6] after one year. All changes were statistically significant (p < 0.005). Discussion and Conclusion: These findings support existing literature, demonstrating that biological therapies effectively reduce the frequency and intensity of migraine attacks and improve patients’ functional status. Notably, the benefits were observed as early as 3 months after therapy initiation and were maintained at 12 months.

• Keywords: master theses, nursing care, monoclonal antibodies, neurology, preventive treatment, nursing role