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Maaitah W, Abdelhay O, Tourkmani A, Azzeh M, Abu-Soud MS, Atiani S. Telemedicine interventions in type 2 diabetes management: a protocol for systematic review and network meta-analysis. BMJ Open 2024; 14:e078100. [PMID: 38388501 PMCID: PMC10884257 DOI: 10.1136/bmjopen-2023-078100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/08/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION The consequences of type 2 diabetes mellitus (T2DM) heavily strain individuals and healthcare systems worldwide. Interventions via telemedicine have become a potential tactic to tackle the difficulties in effectively managing T2DM. However, more research is needed to determine how telemedicine interventions affect T2DM management. This study sets out to systematically analyse and report the effects of telemedicine treatments on T2DM management to gain essential insights into the potential of telemedicine as a cutting-edge strategy to improve the outcomes and care delivery for people with T2DM. METHODS AND ANALYSIS To uncover relevant research, we will perform a comprehensive literature search across six databases (PubMed, IEEE, EMBASE, Web of Science, Google Scholar and Cochrane Library). Each piece of data will be extracted separately, and any discrepancies will be worked out through discussion or by a third reviewer. The studies included are randomised controlled trial. We chose by predefined inclusion standards. After the telemedicine intervention, glycated haemoglobin will be the primary outcome. The Cochrane risk-of-bias approach will be used to evaluate the quality of the included studies. RevMan V.5.3.5 software and RStiduo V.4.3.1 software can be used to analyse the data, including publication bias. ETHICS AND DISSEMINATION Since this research will employ publicly accessible documents, ethical approval is unnecessary. The review is registered prospectively on the PROSPERO database. The study's findings will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023421719.
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Affiliation(s)
- Wasan Maaitah
- Department of Data Science, Princess Sumaya University for Technology, Amman, Jordan
| | - Osama Abdelhay
- Department of Data Science, Princess Sumaya University for Technology, Amman, Jordan
| | - Ayla Tourkmani
- Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammad Azzeh
- Department of Data Science, Princess Sumaya University for Technology, Amman, Jordan
| | - Mohammad S Abu-Soud
- Department of Data Science, Princess Sumaya University for Technology, Amman, Jordan
| | - Serin Atiani
- Department of Data Science, Princess Sumaya University for Technology, Amman, Jordan
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Minen M, George A, Lebowitz N, Katara A, Snyder I. Headache providers' perspectives of headache diaries in the era of increasing technology use: a qualitative study. Front Neurol 2024; 14:1270555. [PMID: 38322798 PMCID: PMC10844531 DOI: 10.3389/fneur.2023.1270555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/31/2023] [Indexed: 02/08/2024] Open
Abstract
Background No matter what type of headache is being considered across various populations, one of the mainstays of headache medicine is headache tracking. This self-management tool enables patients and their providers to understand patients' underlying symptoms and the effects of treatments they have tried. This is important to determining whether headaches are related to menses for women's health, to determining the time of headache occurrence, e.g., hypnic headache, and the location and duration of symptoms, e.g., trigeminal autonomic cephalgia. Prior research has investigated what people with headaches perceive about headache diary use and how people with headaches utilize electronic headache diaries. However, headache providers' perspectives on the important factors related to headache diaries are less known. Previously, using the Modified Delphi Process, a panel of four experts opined what they perceived as the most important factors for a headache diary. We sought to better understand headache providers' perspectives about headache diary/app usage from providers working in various institutions nationwide. Methods We conducted 20 semi-structured qualitative interviews of headache providers across the US from various institutions and asked them their perspectives on headache diary use. We transcribed the interviews, which two independent coders then coded. Themes and subthemes were developed using grounded theory qualitative analysis. Results Six themes emerged: (1) Providers were generally agnostic regarding the headache tracking method, but nearly all recommend the use of smartphones for tracking; (2) Providers had concerns regarding the accessibility of headache trackers; (3) Providers noted benefits to integrating headache tracking data into the EMR but had mixed opinions on how this integration might be done; (4) Providers had mixed opinions regarding the utility and interpretation of the data, specifically regarding data accuracy and efficiency; (5) Providers generally felt that headache tracking lends itself to more collaborative plan management; (6) Providers recommend behavioral health apps for patients but stated that there are few digital behavioral health interventions for headache specifically. Conclusion Interviews of headache providers, recommenders, and users of headache data are vital informants who can provide a robust amount of information about headache diary development, use in different populations, integration, and more.
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Affiliation(s)
- Mia Minen
- Department of Neurology, NYU Langone Health, New York, NY, United States
| | - Alexis George
- Department of Neurology, NYU Langone Health, New York, NY, United States
| | - Naomi Lebowitz
- Barnard College, New York, NY, United States
- Ferkauf Graduate School of Psychology, New York, NY, United States
| | - Aarti Katara
- Barnard College, New York, NY, United States
- Ferkauf Graduate School of Psychology, New York, NY, United States
| | - Ivy Snyder
- Department of Psychology, Yeshiva University, New York, NY, United States
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Leonardi M, Martelletti P, Burstein R, Fornari A, Grazzi L, Guekht A, Lipton RB, Mitsikostas DD, Olesen J, Owolabi MO, Ruiz De la Torre E, Sacco S, Steiner TJ, Surya N, Takeshima T, Tassorelli C, Wang SJ, Wijeratne T, Yu S, Raggi A. The World Health Organization Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders and the headache revolution: from headache burden to a global action plan for headache disorders. J Headache Pain 2024; 25:4. [PMID: 38178049 PMCID: PMC10768290 DOI: 10.1186/s10194-023-01700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
The World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders was developed by WHO to address the worldwide challenges and gaps in provision of care and services for people with epilepsy and other neurological disorders and to ensure a comprehensive, coordinated response across sectors to the burden of neurologic diseases and to promote brain health across life-course. Headache disorders constitute the second most burdensome of all neurological diseases after stroke, but the first if young and midlife adults are taken into account. Despite the availability of a range of treatments, disability associated with headache disorders, and with migraine, remains very high. In addition, there are inequalities between high-income and low and middle income countries in access to medical care. In line with several brain health initiatives following the WHOiGAP resolution, herein we tailor the main pillars of the action plan to headache disorders: (1) raising policy prioritization and strengthen governance; (2) providing effective, timely and responsive diagnosis, treatment and care; (3) implementing strategies for promotion and prevention; (4) fostering research and innovation and strengthen information systems. Specific targets for future policy actions are proposed. The Global Action Plan triggered a revolution in neurology, not only by increasing public awareness of brain disorders and brain health but also by boosting the number of neurologists in training, raising research funding and making neurology a public health priority for policy makers. Reducing the burden of headache disorders will not only improve the quality of life and wellbeing of people with headache but also reduce the burden of neurological disorders increasing global brain health and, thus, global population health.
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Affiliation(s)
- Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | | | - Rami Burstein
- John Hedley-Whyte Professor of Anesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Arianna Fornari
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Richard B Lipton
- Montefiore Headache Center and the Albert Einstein College of Medicine, New York, Bronx, USA
| | - Dimos Dimitrios Mitsikostas
- 1st Neurology Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mayowa Ojo Owolabi
- Faculty of Clinical Sciences, Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway
- Department of Neurology, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
- Division of Brain Sciences, Imperial College London, London, UK
| | | | - Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Shuu-Jiun Wang
- College of Medicine and Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tissa Wijeratne
- Department of Neurology, Sunshine Hospital, St Albans, VIC, Australia
- Australian Institute of Migraine, Pascoe Vale South, Victoria, Australia
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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Robblee J. Telemedicine in Headache Medicine: A Narrative Review. Curr Pain Headache Rep 2023; 27:371-377. [PMID: 37515743 DOI: 10.1007/s11916-023-01141-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE OF REVIEW The purpose of the study is to review and discuss the use of telemedicine in headache medicine. RECENT FINDINGS Before the COVID-19 pandemic, the use of telemedicine for headache was most common in Europe. In recent years, however, telemedicine has been used broadly within headache medicine, including for pediatric patients and behavioral interventions. Several randomized clinical trials have shown that telemedicine is non-inferior to face-to-face visits. Multiple studies have reported substantial benefits associated with telemedicine, including high satisfaction rates, improved access to headache specialists, reduced travel, quicker visits, greater cost-effectiveness, reduced wait times, reduced no-show rates, and the increased comfort of remaining in one's home environment. The main limitation reported is the lack of a physical examination, including fundus assessment. Telemedicine has become a vital tool in headache patient care, with the data supporting its use for patient follow-up in particular.
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Affiliation(s)
- Jennifer Robblee
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
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Berk T, Silberstein S, McAllister P. A Novel Virtual-Based Comprehensive Clinical Approach to Headache Care. J Clin Med 2023; 12:5349. [PMID: 37629391 PMCID: PMC10455593 DOI: 10.3390/jcm12165349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
One major innovation, a result of the coronavirus pandemic, has been the proliferation of telemedicine. Telehealth can help solve the access problems that plague headache medicine, allowing patients in areas with no headache expertise to consult and work with a headache specialist. This is a retrospective chart review of patients seen by Neura Health, a comprehensive app-based telehealth headache center. Patients are seen by a specialist and, in addition to any medical recommendations, are given care plans individualized to their condition and recommendations at the end of their clinical appointments. The primary outcome of this study is a decrease in monthly headache days after 90 days; secondary outcomes include disability as determined by MIDAS score, depression determined by PHQ-9, patients' utilization of emergency department or urgent care resources, as well as their global impression of improvement. The deidentified outcomes of consecutive patients of Neura Health were evaluated from March 2022-March 2023. Subjects were excluded if they did not complete all forms, or if they did not receive a clinical or coaching follow-up appointment within 90 days. A total of 186 consecutive patients at Neura Health were identified during the review period. The median decrease in monthly headache days was 55.0% after a 90 day period, headache severity was decreased by 16.7%, global impression of improvement increased by 60.9%, disability decreased by 38.7%, depression decreased by 12.5% and ER/urgent care visits were decreased by 66.1%. A comprehensive, telehealth-based virtual headache-care model significantly decreased migraine frequency, severity and disability, and is able to decrease ER or urgent care visits.
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Affiliation(s)
- Thomas Berk
- Neura Health, New York, NY 10017, USA
- Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Stephen Silberstein
- Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Peter McAllister
- New England Institute for Neurology and Headache, Stamford, CT 06905, USA;
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Minen MT, George A, Katara A, Lebowitz N, Snyder IC, Busis NA, Lipchitz JM. Headache clinicians' perspectives on the remote monitoring of patients' electronic diary data: A qualitative study. Headache 2023; 63:917-925. [PMID: 37313636 DOI: 10.1111/head.14519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We assessed headache clinicians' viewpoints on potential remote access to patients' digital headache diary data and the practicalities of data utilization. BACKGROUND With the ubiquitous nature of electronic medical records and the existence of remote monitoring (RM) for many medical conditions, there is now the potential for remote symptom monitoring for patients with headache disorders. While patients are asked to utilize headache diaries, clinicians may or may not have access to the data before patient visits, and their perspectives regarding this emerging technology are currently unknown. METHODS After recruiting participants from the National Institutes of Health Pain Consortium Network, the American Headache Society Special Interest Section listservs, and Twitter and Facebook social media platforms, we conducted 20 semi-structured qualitative interviews of headache providers across the United States from various types of institutions and asked them their perspectives on remote access to patient headache diary data. We transcribed the interviews, which were then coded by two independent coders. Themes and sub-themes were developed using inductive content analysis. RESULTS All clinicians felt the RM data needed to be integrated into the electronic medical record. Six themes emerged from the interviews: (i) Clinician perspectives on how RM could be beneficial but at other times could create obstacles/challenges, (ii) operationally, data integration could benefit headache care, (iii) there should be initial logistical considerations for bringing RM into clinical care, (iv) education may need to be provided to both patients and clinicians, (v) there are likely research benefits associated with RM, and (vi) additional suggestions for considering potential integration of RM into practice. CONCLUSIONS While headache clinicians had mixed opinions on the benefits/challenges that RM presents to patient care, patient satisfaction, and visit time, new ideas emerged that may help advance the field.
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Affiliation(s)
- Mia T Minen
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Alexis George
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Aarti Katara
- Barnard College of Columbia University, New York, New York, USA
| | - Naomi Lebowitz
- Barnard College of Columbia University, New York, New York, USA
| | | | - Neil A Busis
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Jessica M Lipchitz
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Virtual Access to Subspecialty Care. Prim Care 2022; 49:557-573. [PMCID: PMC9581700 DOI: 10.1016/j.pop.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Spina E, Tedeschi G, Russo A, Trojsi F, Iodice R, Tozza S, Iovino A, Iodice F, Abbadessa G, di Lorenzo F, Miele G, Maida E, Cerullo G, Sparaco M, Silvestro M, Leocani L, Bonavita S, Manganelli F, Lavorgna L. Telemedicine application to headache: a critical review. Neurol Sci 2022; 43:3795-3801. [PMID: 35075575 PMCID: PMC8786371 DOI: 10.1007/s10072-022-05910-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Migraine affects more than a billion people all over the world and requires critical employment of healthcare resources. Telemedicine could be a reasonable tool to manage people suffering from headaches, and it received a big push from the COVID-19 pandemic. OBJECTIVE This review aims to propose a practical approach for the virtual management of these patients. METHODS To do this, we conducted a literature search, including 32 articles relevant to the topic treated in this review. RESULTS The most challenging step in telemedicine applied to practical neurology remains the clinical assessment, but through a careful headache history and a recently proposed entirely virtual neurological assessment, this hitch can be easily overcome. Electronic diary compilations and virtual administration of disability-measuring scales, conversely, are the key features of effective long-term follow-up although we do not have apps that met the criteria of scientific reliability. Furthermore, tele-rehabilitation seems to be effective and has demonstrated to be a solution to alternatively treat chronic patients at home, and can be considered part of the remote management of headache patients. Moreover, virtual management of headaches finds an application in specific communities of patients, as pediatric patients and for rural communities of low- and middle-income countries suffer from health disparities, with inadequate resources and knowledge gaps. CONCLUSION Telemedicine could be promising for patients with no regular or convenient access to headache specialists and seems to be a priority in managing migraine patients to avoid non-urgent hospitalizations.
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Affiliation(s)
- Emanuele Spina
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy.
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonio Russo
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Rosa Iodice
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | - Stefano Tozza
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | - Aniello Iovino
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | | | - Gianmarco Abbadessa
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Giuseppina Miele
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Maddalena Sparaco
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Marcello Silvestro
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
| | - Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, AOU University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples "Federico II" Via Pansini, 5, 81028, Naples, Italy
| | - Luigi Lavorgna
- 1st Clinic Of Neurology, AOU University of Campania "Luigi Vanvitelli,", Caserta, Italy
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Role of Estrogens in Menstrual Migraine. Cells 2022; 11:cells11081355. [PMID: 35456034 PMCID: PMC9025552 DOI: 10.3390/cells11081355] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Migraine is a major neurological disorder affecting one in nine adults worldwide with a significant impact on health care and socioeconomic systems. Migraine is more prevalent in women than in men, with 17% of all women meeting the diagnostic criteria for migraine. In women, the frequency of migraine attacks shows variations over the menstrual cycle and pregnancy, and the use of combined hormonal contraception (CHC) or hormone replacement therapy (HRT) can unveil or modify migraine disease. In the general population, 18–25% of female migraineurs display a menstrual association of their headache. Here we present an overview on the evidence supporting the role of reproductive hormones, in particular estrogens, in the pathophysiology of migraine. We also analyze the efficacy and safety of prescribing exogenous estrogens as a potential treatment for menstrual-related migraine. Finally, we point to controversial issues and future research areas in the field of reproductive hormones and migraine.
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Headache Diary Mobile Application for Monitoring and Characterizing Posttraumatic Headaches. J Head Trauma Rehabil 2022; 37:171-177. [PMID: 35293366 DOI: 10.1097/htr.0000000000000771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study analyzed the data collected using a headache diary mobile application to characterize posttraumatic headaches (PTHs) in a sample of US veterans. Specifically, we measured patient engagement with the mobile application and compared our findings with previous literature regarding PTHs. SETTING A Headache Center of Excellence (HCoE) in a Veterans Health Administration facility. PARTICIPANTS Forty-nine veterans currently being treated for ongoing PTH-related complaints with English fluency, reliable access to the internet, and a mobile phone. DESIGN Observational study of PTH characteristics using the mobile application over the course of 1 year. MEASURES Main outcome measures were collected via a headache diary mobile application developed for patients to track headache-associated symptoms, headache location, triggers, type, intensity, and duration. Patients also completed a baseline Headache Impact Test (HIT-6) survey. RESULTS In total, 1569 entries were completed during the first year of application deployment. On average, patients completed 2.5 entries per week and used the application for 70 days. They frequently reported associated PTH symptoms of photophobia (56.7%) and headaches triggered by emotional stress (35.1%). Network analyses revealed patterns of co-occurrence in triggers of headache pain, associated symptoms, and headache pain location. Headache pain severity and impact ratings from the headache diary demonstrated convergent validity with the established HIT-6 measure. CONCLUSIONS Headache diary mobile applications are a promising tool for monitoring and characterizing PTHs in veterans. Present results mirror past studies of PTH characteristics. Mobile application headache diaries may be used in both clinical and research settings to monitor headache symptoms and communicate the functional impact of headaches in real time.
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Bentivegna E, Tassorelli C, De Icco R, Sances G, Martelletti P. Tele-healthcare in migraine medicine: from diagnosis to monitoring treatment outcomes. Expert Rev Neurother 2022; 22:237-243. [PMID: 35196206 DOI: 10.1080/14737175.2022.2045954] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION : Primary headaches represent a huge cost in terms of decreased productivity and migraine occupies the first position among disabilities in working population. Migraine has a high incidence, disproportionate to the available primary care centres. In most cases, migraine can be managed through the simple and accurate collection of clinical history, which makes it an ideal candidate for tele-healthcare. AREAS COVERED : In this narrative review we retrace the most important scientific evidence regarding use of tele-healthcare in headache medicine. Over the last few years, it has proved to be a valid and useful tool for the management of migraine. Furthermore, current pandemic has imposed a drastic change in the way of thinking and setting up medicine, forcing clinicians and patients to a huge expansion of telemedicine. EXPERT OPINION : We should permanently insert the culture of telemedicine in the headache care not only in academies and scientific societies, but extend it to specialized hospitals for the treatment of headaches. Only by broadening the old book-based strategy, we will be able to open the door to the multidimensional culture of headache medicine. Experts of excellence centres should set an example and pave the way for the rest of the clinicians.
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Affiliation(s)
- Enrico Bentivegna
- Emergency Medicine Unit, Regional Referral Headache Center, Sant'Andrea University Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Roberto De Icco
- Headache Science and Neurorehabilitation Center, National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Grazia Sances
- Headache Science and Neurorehabilitation Center, National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Paolo Martelletti
- Emergency Medicine Unit, Regional Referral Headache Center, Sant'Andrea University Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
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Reply to letter to editor "Children with migraine and tension-type headache: Do they have behavioral and emotional issues?". Brain Dev 2022; 44:79. [PMID: 34785119 DOI: 10.1016/j.braindev.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022]
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