Headache teleconsultation in the era of COVID‐19: Patients' evaluation and future directions

Dias, Leonor; Martins, Berta; Pinto, Maria João; Rocha, Ana Luísa; Pinto, Madalena; Costa, Andreia

doi:10.1111/ene.14915

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…Our results align with previous studies ( 28 , 30 , 33 ) with 67.3% of respondents expressing a preference for mixed-mode appointments in the future. Contrary to the United States, where only 7.1% of headache patients declined telemedicine ( 16 ), 29.0% of our respondents expressed a preference for exclusively in-person consultations in the future.…”

Section: Discussionsupporting

confidence: 92%

“…An intriguing finding from our study emerged suggesting that respondents who had their primary neurology appointments remotely were less likely to choose teleconsultations in the future. A plausible explanation for this could be the absence of physical interactions, a component that patients often deem essential, underscoring the advantage of a hybrid approach that combines initial in-person consultations ( 13 , 29 , 30 , 33 ). Furthermore, our study revealed that patients who identified more disadvantages in telemedicine care and had lower evaluations of previous remote experiences with a general practitioner (GP) showed a greater preference for in-person visits.…”

Section: Discussionmentioning

confidence: 99%

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Evolving migraine management: Lithuania's telemedicine experience

Andruskevicius,

Petrosian,

Dapkute

et al. 2024

Front. Neurol.

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IntroductionCOVID-19 challenges have underscored the potential of telemedicine in migraine management. This study focuses on assessing patients' telemedicine experience for headache management in Lithuania and identifying key barriers and facilitators for its wider use.MethodsA nationwide e-survey was conducted in 2023 via the Lithuanian Association of Migraine Patients' website, social media platforms, websites of public and private healthcare facilities, and migraine self-help groups. The survey covered sociodemographics, migraine characteristics, previous experience with teleconsultations for headaches with neurologists and general practitioners (GP), perceived advantages and disadvantages of telehealth, and preferred future consultation types.ResultsEight hundred and forty seven respondents with a confirmed migraine diagnosis were analyzed. The majority were female (97.2%), with a median age of 35 (IQR 30–42) years and an average of 5 (IQR 3–9) monthly headache days (MHDs). 7.0% of respondents had chronic migraine (CM). Prior teleconsultations for headaches were reported by 35.2% of respondents, 26.2% with a GP and 17.0% with a neurologist (p < 0.0001). Teleconsultation outcomes included continuation of a prescribed treatment (84.7% for GPs and 83.3% for neurologists, p = 0.7295), initiation of new acute medications (12.2% for GPs with 70.4% reported as effective and 27.1% for neurologists with 84.6% effective, p = 0.0005 and p < 0.0001, respectively). Reasons for not undergoing remote neurology consultations: the lack of inquiry (69.7%), unavailability from neurologists (18.1%) and respondent's opposition to remote consultations (12.2%). Patients evaluated their experience with remote neurology services better than that of GPs (p = 0.0289). 67.3% of respondents preferred a mixed-mode approach for future consultations. In-person-only preference (29.0%) correlated with multiple factors, including history of remote primary neurology consultations (OR 5.89, p = 0.0022), lower education (OR 2.20, p = 0.0001), physically demanding work (OR 1.95, p = 0.0001), and number of drawbacks in telemedicine identified (OR 1.30, p < 0.0001), and worse experience of a prior remote GP consultation (OR 0.704, p < 0.0001). The main indicator of preference for remote-only consultations was the perception of fewer telemedicine disadvantages (OR 0.503, p = 0.0007).ConclusionsOur findings confirm that telemedicine contributes to effective migraine management and is used limitedly in Lithuania. Despite one-third of respondents having experienced teleconsultations, significant barriers remain. Our study highlights a clear preference for a hybrid consultation type.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Evolving migraine management: Lithuania's telemedicine experience

Andruskevicius,

Petrosian,

Dapkute

et al. 2024

Front. Neurol.

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“…Additionally, this postvisit survey supports the claim of previous literature [1][2][3][4] that patients have a high level of satisfaction with telemedicine. Upon review of survey responses, especially free-text responses, patients appreciate the convenience of accessing the health care system virtually with EMCs.…”

Section: Comparison To the Current Literaturesupporting

confidence: 87%

“…The COVID-19 pandemic accelerated patient use and acceptance of telemedicine platforms. Multiple studies across different subspecialties have demonstrated patient acceptance of and satisfaction with telemedicine visits [1][2][3][4]. A survey of 7477 patients with type 1 diabetes in 89 countries found that 86% of respondents saw utility in virtual appointments and 75% planned to use telemedicine appointments again [5].…”

Section: Introductionmentioning

confidence: 99%

Using Virtual Emergency Medicine Clinicians as a Health System Entry Point (Virtual First): Cross-Sectional Survey Study

Potter¹,

Watson²,

Gardner³

et al. 2023

J Med Internet Res

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Background The COVID-19 pandemic accelerated the use and acceptance of telemedicine. Simultaneously, emergency departments (EDs) have experienced increased ED boarding. With this acceptance of telemedicine and the weighty increase in patient boarding, we proposed the innovative Virtual First (VF) program to leverage emergency medicine clinicians’ (EMCs) ability to triage patients. VF seeks to reduce unnecessary ED visits by connecting patients with EMCs prior to seeking in-person care rather than using traditional ED referral systems. Objective The goal of this study is to investigate how patients’ access to EMCs from home via the establishment of VF changed how patients sought care for acute care needs. Methods VF is a synchronous virtual video visit at a tertiary care academic hospital. VF was staffed by EMCs and enabled full management of patient complaints or, if necessary, referral to the appropriate level of care. Patients self-selected this service as an alternative to seeking in-person care at a primary care provider, urgent care center, or ED. A postvisit convenience sample survey was collected through a phone SMS text message or email to VF users. This is a cross-sectional survey study. The primary outcome measure is based on responses to the question “How would you have sought care if a VF visit was not available to you?” Secondary outcome measures describe valued aspects and criticisms. Results were analyzed using descriptive statistics. Results There were 3097 patients seen via VF from July 2021 through May 2022. A total of 176 (5.7%) patients completed the survey. Of these, 87 (49.4%) would have sought care at urgent care centers if VF had not been available. There were 28 (15.9%) patients, 26 (14.8%) patients, and 1 (0.6%) patient that would have sought care at primary care providers, EDs, or other locations, respectively. Interestingly, 34 (19.3%) patients would not have sought care. The most valued aspect of VF was receiving care in the comfort of the home (n=137, 77.8%). For suggested improvements, 58 (33%) patients most commonly included “Nothing” as free text. Conclusions VF has the potential to restructure how patients seek medical care by connecting EMCs with patients prior to ED arrival. Without the option of VF, 64.2% (113/177) of patients would have sought care at an acute care facility. VF’s innovative employment of EMCs allows for acute care needs to be treated virtually if feasible. If not, EMCs understand the local resources to better direct patients to the appropriate site. This has the potential to substantially decrease patient costs because patients are given the appropriate destination for in-person care, reducing the likelihood of the need for transfer and multiple ED visits.

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“…Lockdowns, remote work, and increased stress led to a surge in reported craniofacial pain cases [ 15 ]. Lately, virtual consultations, telemedicine, and tailored home-based exercises have become essential tools for managing pain while minimizing in-person interactions [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Craniofacial Pain Management in Severe COVID-19 Patients During the Pandemic Peak in Kosovo: A Comprehensive Approach

Krasniqi,

Disha,

Krasniqi

et al. 2023

Cureus

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Background This cross-sectional study aims to evaluate pain management's success in limiting admissions and assesses remote care's effectiveness for optimal pain relief. By utilizing data from severe COVID-19 inpatients in Prishtina, Kosovo, this study offers insights into the challenges posed by the pandemic and innovative care approaches aimed at improving patient well-being. Methodology This cross-sectional study includes 55 patients with severe COVID-19 after hospital discharge. All study participants completed the questionnaire in the presence of a clinical pharmacologist. The questionnaire of this study consisted of three parts: sociodemographic data (first part), the Intensity and Characteristics of Toothache (IaCofT) and headache (second part), and pharmacological treatment of headache and dental pain (third part). The questionnaire on IaCofT and headache was created with some modifications of the Modified Dental Pain Screening Questionnaire (M-DePaQ). Descriptive statistics were conducted using Prism version 10.0.1 (Windows and Mac). Results According to the study data, 89.1% ( n = 49) of the participants experienced pain during hospitalization with COVID-19, while 72.72% ( n = 40) of them experienced pain after hospital discharge. Of the participants, 32.7% ( n = 18) experienced dental pain, whereas 60% (n = 33) reported having headaches. Regarding the pain scale, more than two-thirds ( n = 40, 72.72%) of the participants had moderate to moderately severe pain, and in 70.9% ( n = 39) of the cases, the pain occurred episodically. The absolute majority ( n = 53, 96.4%) of study participants reported the use of analgesics for pain management. Paracetamol ( n = 46, 83.6%) and ibuprofen ( n = 14, 25.5%) were the most commonly used analgesics for pain management. Conclusions This study highlighted the prevalence of headache and acute dental pain in these patients. The majority of the study participants were convinced by the healthcare system and were highly dependent on pharmacological treatment for headaches and acute toothache during the COVID-19 peak. The study results showed that the pain was proven to be successfully treated pharmacologically with analgesics such as paracetamol, ibuprofen, and diclofenac. Telemedicine is expected to become an important healthcare practice in the post-COVID-19 era. Therefore, the introduction of this service could be considered.

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Headache teleconsultation in the era of COVID‐19: Patients' evaluation and future directions

Cited by 11 publications

References 26 publications

Evolving migraine management: Lithuania's telemedicine experience

Evolving migraine management: Lithuania's telemedicine experience

Using Virtual Emergency Medicine Clinicians as a Health System Entry Point (Virtual First): Cross-Sectional Survey Study

Craniofacial Pain Management in Severe COVID-19 Patients During the Pandemic Peak in Kosovo: A Comprehensive Approach

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