Telephone follow‐up on treatment and patient satisfaction at a Danish tertiary headache center: A prospective study

Abstract

Objective We investigated whether telephone follow‐up consultations could lead to appropriate adjustment of treatments and a higher degree of patient satisfaction among patients with migraine and tension‐type headache (TTH). Background Migraine and TTH are disabling headache forms requiring optimized treatment. Methods In a prospective, non‐randomized, quality control study with controls comparing telephone‐interview intervention (TeII) with business‐as‐usual (BAU) treatment, we included newly referred patients with migraine and/or TTH. The TeII group was contacted by telephone by healthcare professionals at 8 and 16 weeks after the first visit addressing headache treatment. Electronic questionnaires were sent to all participants before the first visit and after 6 months. Predefined outcomes were number of patients with change in preventive and acute medication; change in headache frequency; migraine frequency; scores from the eight‐item Headache Under‐Response to Treatment (HURT‐8) questionnaire, Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HADS); and patient satisfaction after 6 months. Results From May 2020 to April 2021, there were 230 patients enrolled in the TeII program, whereof 96 patients were included in the analysis. For the BAU group, 91 patients with similar sex and age distribution were identified via medical‐record reviews in the same period. More patients in the TeII group than in the BAU group had a change in acute medication (27/96 [28%] vs. five of 91 [6%], p < 0.001) and preventive medication (28/96 [29%] vs. 12/91 [13%], p = 0.006). Headache days per month decreased in the TeII group (−4.6, 95% confidence interval [CI] −6.5 to −2.7; p = 0.001) and the BAU group (−2.5, 95% CI −4.6 to −0.4; p = 0.018), without significant difference between the groups (p = 0.080). There was no difference in migraine frequency between the groups (TeII: 1.0 day, 95% CI, −1.3 to 1.0; BAU: 1.0 day, 95% CI, −2.5 to 0.5; p = 0.718) or HURT‐8 score (TeII: 10.5, 95% CI 9.5–11.5; BAU: 13.0, 95% CI 11.7–14.2; p = 0.053). There were no changes in the ISI score (TeII: 1.0, interquartile range [IQR] 6; p = 0.152; BAU: 0.5, IQR 4.5; p = 0.824), HADS‐Anxiety score (TeII: −5, IQR 5.3; p = 0.186; BAU: 1.0, IQR 4.0; p = 0.445), or HADS‐Depression score (TeII: 0.0, IQR 3.0; p = 0.163; BAU: 0.0, IQR 2.0; p = 0.303) in any of the groups. There was a higher degree of patient satisfaction in the TeII group compared with the BAU group in treatment (median [IQR] score 4 [3–5] vs. 3 [3–4], p < 0.001), headache improvement (median [IQR] 3 [2–4] vs. 2 [1–3], p = 0.002), the headache program (median [IQR] 4 [3–5] vs. 3 [3–4], p < 0.001), and information (median [IQR] 4 [3–5] vs. 3 [3–4], p = 0.005). Conclusion Patients with migraine and/or TTH benefit from a telephone follow‐up approach within the first 6 months of their treatment course in terms of more efficient treatment and higher patient satisfaction.

Consensus recommendations on the role of nurses in headache care: A European e-Delphi study

“…This systematic set-up could decrease waiting time for patients and increase efficiency. In the study of follow-up telephone consultations for patients after eight and 16 weeks after initial visit, Carlsen et al found that patients benefit from more efficient treatment and experience increased patient satisfaction (42). That said, it is also worth considering that patients will present with different needs.…”

Evolving migraine management: Lithuania's telemedicine experience

“…Multiple studies have supported the effectiveness and patient satisfaction with teleconsultations, in addition to some indicating no significant difference from in-person visits ( 11 , 15 , 22 – 24 ). In our study, the rates of prescribing new treatments proved to be lower compared to those reported in similar study by Chiang et al ( 16 ).…”

Evaluating Headache and Facial Pain in a Headache Diagnostic Laboratory: Experiences from the Danish Headache Center

“…We, therefore, conducted a study investigating if telephone follow-up consultations resulted in better adjustment of treatments and a higher degree of patient satisfaction in migraine and TTH patients [ 44 ]. The study was conducted as a prospective quality control study with controls receiving business-as-usual treatment [ 47 ]. The telephone interview intervention group was contacted by telephone for typically 5–10 min 8 and 16 weeks after their first visit to the headache center.…”

“…The telephone interview intervention group was contacted by telephone for typically 5–10 min 8 and 16 weeks after their first visit to the headache center. In total, 96 telephone interview intervention patients and 91 business-as-usual patients were included in the analysis [ 47 ]. More patients in the telephone interview group than in the business-as-usual group had a change in acute medication and preventive medication.…”

“…More patients in the telephone interview group than in the business-as-usual group had a change in acute medication and preventive medication. We did not find differences in headache reduction between the groups, but there was a higher degree of patient satisfaction in the telephone interview group compared with the business-as-usual group [ 47 ]. The study shows that two short simple telephone follow-ups within the first 6 months of migraine and TTH patient treatment courses result in more efficient treatment and higher patient satisfaction.…”