Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 4, 2021
Date Accepted: Sep 12, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
One-year remission rate of chronic headache. Results from a randomized controlled trial comparing video- and face-to-face consultations at specialist in Northern Norway
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 specialist for optimal health care management.
Objective:
To determine whether video-consultations are non-inferior to face-to-face consultations in treating chronic headache patients referred to specialist in Northern Norway.
Methods:
Patients included in the study were recruited from general practice referrals to specialist at a neurological department in North Norway (Tromsø) and diagnosed according to the International Headache Society (IHS) classification system. In a randomized controlled design, one-year remission rate of chronic headache (change from ≥15 to <15 headache days pr. month during the last three months), patient satisfaction with 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 (ClinicalTrials.gov; id. NCT02270177). 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 specialist over 2.5 years, 233 (58.0%) were classified as CH and included in the present study. Response-rates were 86/120 (71.7%) in the video-group and 76/113 (67.3%) in the face-to-face group. One-year-remission from chronic headache was achieved in 37/86 (43.0%) in the video-group and 30/76 (39.5%) in the traditional group, P=.75. Patient satisfaction with consultations were 32 (86.5%) (video) and 28 (93.3) (traditional), P=.37. Patient satisfaction with consultations were 32 (86.5%) (video) and 28 (93.3) (face-to-face), P=.25. Eleven (29.7%) in the face-to-face-group and 16 (53.3%) consulted general practitioners during the follow-up period, P=.056 and median (IQR range) number of consultations were 1 (0-13) respectively 1.5 (0-15), P=.19.
Conclusions:
One-year-remission rate from CH was about 40% regardless of consultation form. Likewise, patient´s satisfaction with consultation and need for follow-up visits in general practice post-consultation were 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. Clinical Trial: ClinicalTrials.gov (id. NCT02270177)
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