Video consultations in medication overuse headache. A randomized controlled trial

Area of Science:

• Neurology
• Telemedicine
• Pain Management

Background:

• Medication overuse headache (MOH) poses a significant challenge in neurological practice.
• Traditional consultations are the standard of care for managing MOH.
• The efficacy of telehealth, specifically video consultations, for MOH management requires further investigation.

Purpose of the Study:

• To determine if video consultations are noninferior to traditional consultations for patients with medication overuse headache (MOH).
• To compare headache burden, pain intensity, and headache frequency between video and traditional consultation groups.

Main Methods:

• A randomized controlled trial (RCT) was conducted with patients referred to a neurological clinic.
• Participants (n=102) were randomized to either video consultations (n=51) or traditional consultations (n=51).
• Outcomes including Headache Impact Test (HIT-6), headache frequency, and Visual Analogue Scale (VAS) for pain were assessed at baseline, 3 months, and 1 year.

Main Results:

• No significant differences were observed in HIT-6 scores, headache frequency (<15 days/month), or VAS pain scores between the video and traditional consultation groups at 1-year follow-up.
• HIT-6 scores improved from baseline to 12 months in both groups, with similar changes observed.
• VAS scores showed comparable improvements in both groups from baseline to 12 months.

Conclusions:

• Video consultations are noninferior to traditional consultations in managing patients with medication overuse headache (MOH).
• Telehealth, particularly video consultations, presents a viable and effective alternative for managing MOH patients.
• This supports the integration of telemedicine into routine neurological care for chronic headache disorders.