Abstract Details

Title A New Vision in Headache Medicine: A Survey of Headache Specialists' Utilization of Telehealth in Their Practice

Topic Headache

Presentation(s) Headache Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 146

Background The rapid roll-out of telehealth during the covid-19 pandemic impacted headache specialists.

Objective

To assess the practice of telehealth for headache visits in the US.

Design/Methods American Headache Society (AHS) members were emailed an anonymous survey (9/9/20-10/12/20) to complete if they had logged >2 months or 50+ headache visits via telehealth.

Results

225 of 1348 (16.7%) AHS members responded. Most were female (59.8%; 113/189). Mean age was 47.4+11.8 (N=154). The vast majority were MD/DOs (83.2%;158/190) and NP/PAs (14.7%; 28/190), and most (65.1%; 123/189) were in academia. Years in practice were: 0-3: 28; 4-10: 58; 11-20: 42; 20+: 61. Mean number of telehealth visits was 199.4 + 214.8 in prior 3 months. Respondents were “comfortable” or “very comfortable” treating via telehealth a (a) new patient with a chief complaint of headache (137/185); (b) follow-up for migraine (184/186); (c) follow-up for secondary headache (116/182). About half (51.1%; 97/190) offer urgent telehealth. Beyond being unable to perform in-person procedures, top barriers cited were conducting parts of the neurologic exam (157/189), absence of vital signs (116/189), and socio-economic/technologic barriers (88/189).

The top positive attributes were patient convenience (185/190), reducing patient travel stress (172/190), patient cost reduction (151/190), flexibility with personal matters (128/190), patient comfort at home (114/190), and patient medications nearby(103/190). Only 20% (31/155) of providers said that telehealth visit length differed compared to in person visits and 55.3% (105/190) believe the no-show rate improved. Providers were “interested”/”very interested” (128/188) in digitally prescribing headache apps and “interested”/”very interested” (121/189) in the remote monitoring of patient symptoms.

Conclusions Respondents were comfortable treating migraine patients via telehealth They note positive attributes for patients and how access to care may be improved. Technology innovations (remote vital signs, digitally prescribing headache apps) and remote symptom monitoring are areas of interest for headache specialists and warrant future research.

Authors/Disclosures
Mia T. Minen, MD, FAAN (NYULMC Neurology) PRESENTER	The institution of Dr. Minen has received research support from NIH. Dr. Minen has received intellectual property interests from a discovery or technology relating to health care. Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a First Contact-Primary Care Advisory Board Member with American Headache Society . Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PCORI grant on migraine evidence based map for stakeholders with ECRI .
Lauren D. Strauss, DO (Wake Forest Univrsity Baptist Medical Center)	Dr. Strauss has a non-compensated relationship as a Secretary with Southern Headache Society that is relevant to AAN interests or activities.
Kayla Kaplan	Kayla Kaplan has nothing to disclose.
Annika Ehrlich, NP (UCSF Headache Center)	Ms. Ehrlich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie Pharmaceuticals. Ms. Ehrlich has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Ms. Ehrlich has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Ms. Ehrlich has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Ms. Ehrlich has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of the Pacific. Ms. Ehrlich has received personal compensation in the range of $500-$4,999 for serving as a Meditation teacher with Miles for Migraine. Ms. Ehrlich has a non-compensated relationship as a Working Group Member with Alliance for Patient Access that is relevant to AAN interests or activities. Ms. Ehrlich has a non-compensated relationship as a Board member with Alliance for Headache Disorders Advocacy that is relevant to AAN interests or activities. Ms. Ehrlich has a non-compensated relationship as a Medical reviewer (volunteer) with Migraine Again that is relevant to AAN interests or activities.
Nathan L. Bennett, MD (Preferred Headache Center)	Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan / AbbVie. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Bennett has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Allergan / Abbvie. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Amgen. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven.
Paul B. Rizzoli, MD, FAAN (BW/F Neurology)	Dr. Rizzoli has received personal compensation in the range of $0-$499 for serving as a Consultant for CVS. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Rizzoli has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of New England. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Harvard Health Publishing. The institution of Dr. Rizzoli has received research support from Abbvie. Dr. Rizzoli has received publishing royalties from a publication relating to health care.
Nina Y. Riggins, MD, FAAN (Headache Center of Excellence)	Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG Gerson Lehrman Group . Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. The institution of Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. The institution of Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amneal Pharmaceuticals. Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NeurologyLive. The institution of Dr. Riggins has received research support from ElectroCore (GammaCore). The institution of Dr. Riggins has received research support from Miles for Migraine. The institution of Dr. Riggins has received research support from Eli Lilly. Dr. Riggins has received publishing royalties from a publication relating to health care. Dr. Riggins has received publishing royalties from a publication relating to health care. Dr. Riggins has received publishing royalties from a publication relating to health care. Dr. Riggins has a non-compensated relationship as a PI on research study with TheraSpecs that is relevant to AAN interests or activities. Dr. Riggins has a non-compensated relationship as a Advisory Board with NeurologyLive that is relevant to AAN interests or activities. Dr. Riggins has a non-compensated relationship as a Member of the Board with Miles for Migraine that is relevant to AAN interests or activities. Dr. Riggins has a non-compensated relationship as a PI in the study which used sphenocath device with Dolor Technologies that is relevant to AAN interests or activities. Dr. Riggins has a non-compensated relationship as a PI with Theranica that is relevant to AAN interests or activities.