Abstract
ObjectiveTo test the hypothesis that the effect of video consultations is noninferior to traditional consultations in managing patients with overuse headache (MOH).Materials and MethodsPatients were recruited from referrals to a neurological clinic. In a randomized controlled trial (RCT), headache burden measured by headache impact test (HIT‐6) and frequency of headache days <15 per month and visual analogue pain scale (VAS) at baseline, 3 months and 1 year were compared between groups consulted by video‐ (n = 51) and traditional consultations (n = 51) in a post hoc analysis.ResultsThe overall response rate was 74.5%. HIT‐6 changed from 66.3 (SD = 4.7) to 60.0 (SD = 9.1) from baseline to 12 months in participants randomized to video consultations and from 65.8 (SD = 3.7) to 58.4 (SD = 8.3) in the group consulted traditionally (95% CI −2.3 to 6.5, p = 0.44). Frequency of headache days <15 per month at 1‐year follow‐up were 9 (23.1%) respectively 10 (27.0%), p = 0.60. In the video group, VAS improved by 2.3 points compared to 2.4 in the traditional group from baseline to 12 months (95% CI −1.2 to 1.2, p = 0.76). Analyses of repeated measurements comparing HIT‐6 and VAS over two points of time in the two groups were insignificant.ConclusionThe effect of video consultations is noninferior to traditional consultations in managing MOH patients. Using video may be a good alternative in consulting patients with MOH.
Highlights
Medication overuse headache (MOH) is common with a prevalence ranging from 0.5% to 7.2% reported in population studies, and is es‐ timated to cause about half of chronic headache cases (Aaseth et al, 2008; Westergaard, Glumer, Hansen, & Jensen, 2014)
managing patients with overuse headache (MOH) is a common group of headache patients among those referred to specialist for second opinion from general
We investigated whether use of video consultations is effective in the treatment of patients with MOH referred for second opinion to a neurological outpa‐ tient department
Summary
Medication overuse headache (MOH) is common with a prevalence ranging from 0.5% to 7.2% reported in population studies, and is es‐ timated to cause about half of chronic headache cases (Aaseth et al, 2008; Westergaard, Glumer, Hansen, & Jensen, 2014). Since the presence of migraine or another primary headache disorder is a necessary precursor for the development of MOH, this add‐on headache is an important focus for prevention and reduction of headache‐related disability (Munksgaard & Jensen, 2014). MOH is a common group of headache patients among those referred to specialist for second opinion from general. BEKKELUND and MÜLLER practitioners (Muller, Alstadhaug, & Bekkelund, 2016a) It is, important to be aware that consequences of painkiller use in head‐ ache patients may be unrecognized (Bekkelund & Salvesen, 2002). The costs per visit for rural headache patients visiting a headache specialist in North Norway were estimated to €249 (travel cost) and €234 (loss of income; Muller, Alstadhaug, & Bekkelund, 2016b). Ac‐ ceptability and feasibility using video in consulting nonacute headache patient were favourable (Muller et al, 2016b)
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