Abstract
BackgroundMigraine affects more than a billion people all over the world and requires critical employment of healthcare resources. Telemedicine could be a reasonable tool to manage people suffering from headaches, and it received a big push from the COVID-19 pandemic.ObjectiveThis review aims to propose a practical approach for the virtual management of these patients.MethodsTo do this, we conducted a literature search, including 32 articles relevant to the topic treated in this review.ResultsThe most challenging step in telemedicine applied to practical neurology remains the clinical assessment, but through a careful headache history and a recently proposed entirely virtual neurological assessment, this hitch can be easily overcome. Electronic diary compilations and virtual administration of disability-measuring scales, conversely, are the key features of effective long-term follow-up although we do not have apps that met the criteria of scientific reliability. Furthermore, tele-rehabilitation seems to be effective and has demonstrated to be a solution to alternatively treat chronic patients at home, and can be considered part of the remote management of headache patients. Moreover, virtual management of headaches finds an application in specific communities of patients, as pediatric patients and for rural communities of low- and middle-income countries suffer from health disparities, with inadequate resources and knowledge gaps.ConclusionTelemedicine could be promising for patients with no regular or convenient access to headache specialists and seems to be a priority in managing migraine patients to avoid non-urgent hospitalizations
Highlights
Migraine affects more than a billion of people all over the world representing the second disease for years lived with disability, the first one in people under 50 years of age [1] requiring a critical employment of healthcare resources
Headache healthcare will occupy an important role in the future of telemedicine because people who suffer from migraine represent approximately the 28% of any neurological outpatient clinic and because headache has so many different patterns of presentation that can lead to the possibility of being pointed out by other professional figures such as internist or gynaecologist, and addressed to the neurologist [2]
The primary goal of this paper is to propose an approach based on the available literature to manage headache patients in a virtual way, from the first visit to follow-up and therapeutical management, assuming that technical needs for a correct remote interaction have been properly satisfied
Summary
Migraine affects more than a billion of people all over the world representing the second disease for years lived with disability, the first one in people under 50 years of age [1] requiring a critical employment of healthcare resources. With the COVID-19 pandemic, many approaches have been proposed to manage neurological patients with telemedicine; the American Academy of Neurology developed a guidance on technology best practices and regulations [12], specific for the coronavirus emergency, and suggestion on how to perform neurologic examinations remotely. Migraine affects more than a billion people all over the world and requires critical employment of healthcare resources. Telerehabilitation seems to be effective and has demonstrated to be a solution to alternatively treat chronic patients at home, and can be considered part of the remote management of headache patients. Conclusion Telemedicine could be promising for patients with no regular or convenient access to headache specialists and seems to be a priority in managing migraine patients to avoid non-urgent hospitalizations
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