Telemedicine Comparable to In-Office Visits for Associated Improvements in Migraine Disability

Telemedicine delivered over 1 year to patients with severe migraine-related disability was comparable to in-office visits for improving migraine disability, number of headache days, and average headache severity at 12 months, according to study results published in Cephalalgia.

A total of 45 consecutive patients with migraine were recruited from the study investigator’s practice. Patients were randomly assigned to receive follow-up care with either telemedicine (n=22) or in-office visits (n=18). The primary outcome of the study was the percentage of visits using telemedicine completed as scheduled. The researchers also examined changes in headache disability with the Migraine Disability Assessment Scale (MIDAS) from baseline to 12 months.

The percentage of care visits completed as scheduled was 92.7% for telemedicine and 87% for in-office visits (95% CI, 0.61-6.17; P =.3). There was no difference between telemedicine and in-office visits with regard to the likelihood of experiencing a ≥50% reduction in MIDAS score (odds ratio [OR], 1.25; 95% CI, 0.29-5.54; P =.77), nor was there any difference between the 2 groups with regard to the change in the number of headache days (OR, 1.12; 95% CI, 0.25–5.09; P =.88) or headache severity (OR, 0.29; 95% CI, 0.05–1.35; P =.12). In-office visits were associated with more time spent face-to-face with a physician compared with telemedicine (34 minutes vs 25 minutes, respectively; P =.01).

Study limitations were the inclusion of mostly patients with commercial or national government insurance and the somewhat large number of uncompleted visits during the trial.

Findings from this study support that telemedicine “is a feasible mode of treatment and effective alternative to in-office visits for follow-up migraine care,” concluded the researchers. They also note that “physician productivity could be higher with telemedicine” and that “patients may get better access [to care] because of its convenience.”

Disclosure: A study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures. This clinical trial was supported by Merck, Inc. Please see the original reference for a full list of authors’ disclosures.

Reference

Friedman DI, Rajan B, Seidmann A. A randomized trial of telemedicine for migraine management [published online August 26, 2019]. Cephalalgia. doi:10.1177/0333102419868250