@Article{info:doi/10.2196/30151,
author="Bekkelund, Svein Ivar
and M{\"u}ller, Kai Ivar",
title="One-Year Remission Rate of Chronic Headache Comparing Video and Face-to-Face Consultations by Neurologist: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="13",
volume="23",
number="12",
pages="e30151",
keywords="chronic headache; remission; video consultation; telemedicine; eHealth; digital consultation; consultation; treatment; follow-up; RCT; randomized controlled trial",
abstract="Background: Chronic headache causing severe headache-related disability for those affected by the disease is under- or misdiagnosed in many cases and therefore requires easy access to a specialist for optimal health care management. Objective: The goal of the research is to determine whether video consultations are noninferior to face-to-face consultations in treating chronic headache patients referred to a specialist in Northern Norway. Methods: Patients included in the study were recruited from general practice referrals to a specialist at a neurological department in Northern Norway (Troms{\o}) and diagnosed according to the International Headache Society classification system. In a randomized controlled design, the 1-year remission rate of chronic headache (change from ≥15 to <15 headache days per month during the last 3 months), patient satisfaction with a specialist consultation, and need for follow-up consultations by general practitioners were compared between groups consulted by video and face-to-face in a post hoc analysis. Data were collected by interview (baseline) and questionnaire (follow-up). Results: From a baseline cohort of 402 headache patients consecutively referred from general practice to a specialist over 2.5 years, 58.0{\%} (233/402) were classified as chronic headache and included in this study. Response rates were 71.7{\%} (86/120) in the video group and 67.3{\%} (76/113) in the face-to-face group. One-year remission from chronic headache was achieved in 43.0{\%} (37/86) in the video group and 39.5{\%} (30/76) in the face-to-face group (P=.38). Patient satisfaction with consultations were 86.5{\%} (32/37; video) and 93.3{\%} (28/30; face-to-face; P=.25). A total of 30{\%} (11/37) in the video group and 53{\%} (16/30) in the face-to-face group consulted general practitioners during the follow-up period (P=.03), and median number of consultations was 1 (IQR 0-13) and 1.5 (IQR 0-15), respectively (P=.19). Conclusions: One-year remission rate from chronic headache was about 40{\%} regardless of consultation form. Likewise, patient satisfaction with consultation and need for follow-up visits in general practice post consultation was similar. Treating chronic headache patients by using video consultations is not inferior to face-to-face consultations and may be used in clinical neurological practice. Trial Registration: ClinicalTrials.gov NCT02270177; https://clinicaltrials.gov/ct2/show/NCT02270177 ",
issn="1438-8871",
doi="10.2196/30151",
url="https://www.jmir.org/2021/12/e30151",
url="https://doi.org/10.2196/30151",
url="http://www.ncbi.nlm.nih.gov/pubmed/34898455"
}