Telemedicine in Pediatric Headache: A Review and Practical Implementation

Abstract

Purpose of Review The purpose of this review was to summarize the current literature about telemedicine in pediatric headache and to provide practical guidance for its implementation. Recent Findings There are few studies dedicated to telemedicine in pediatric headache, and existing studies are small. Patients and families report high levels of satisfaction with telemedicine, and most are willing to continue telemedicine visits in the future. Telemedicine demonstrated similar reductions in headache frequency, severity, and duration as patients treated in-person. Remotely delivered psychologic interventions have some utility in reducing headache severity acutely. Families feel telemedicine reduces geographic and financial barriers to care. Summary Telemedicine in pediatric headache is a growing field. While there is limited research available, it appears safe, efficacious, and feasible. Headache-related outcomes, including frequency, severity, and duration, were similar amongst telemedicine and in-person visits. Future studies should include larger sample sizes and detailed analysis of adverse outcomes.

Digital headache self‐management interventions for patients with a primary headache disorder: A systematic review of randomized controlled trials

“…Patient preferences for use of digital technologies to promote headache management indicate a need for health‐care providers to consider recommending digital tools that may benefit patients in the context of clinical care 25,27–29 . Despite the need for larger RCTs and development testing of culturally informed digital headache tools, the present literature suggests that self‐directed digital interventions and combination digital and in‐person interventions are promising.…”

“…25,[27][28][29] Despite the need for larger RCTs and development testing of culturally informed digital headache tools, the present literature suggests that self-directed digital interventions and combination digital and in-person interventions are promising. Patients may benefit from a referral for headache management interventions that combine digital technologies with health-care provider interactions or recommendations for self-directed digital headache interventions, which may be a more feasible approach in busy clinic settings.…”

“…Digital health interventions and tools may also be more cost effective, although issues related to insurance reimbursement may interfere with implementation in certain settings. Digital health tools are certainly more customizable to individual patient preferences and treatment goals than static handouts commonly used in doctors' offices to disseminate headache self‐management information 25–29 . Patients with migraine, in particular, have expressed preferences for use of digital platforms for intervention delivery 28,29 and digital tools (e.g., apps) to support adherence to their headache regimen 25,27 .…”

The effects of COVID‐19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth

“…Inability to carry out the focused physical examination which is especially important for children below 2 years of age 87,89,90,93 …”

Telemedicine application to headache: a critical review

“…Similarly, a recent narrative review pointed out the efficacy of behavioral therapy for migraine patients administered through electronic health (e-health–telecommunication-based health). On the other side, the same review showed the absence of specific mobile app (m-health) to provide these therapies [ 29 ]. This novel strategy could be incorporated into the multidisciplinary approach to migraineurs, since it may support and engage patients between outpatient visits and encourage them to play a proactive role in the management of their pain.…”