神经内科医生视频和面对面咨询慢性头痛的一年缓解率比较：随机对照试验。

One-Year Remission Rate of Chronic Headache Comparing Video and Face-to-Face Consultations by Neurologist: Randomized Controlled Trial.

机构信息

Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.

出版信息

J Med Internet Res. 2021 Dec 13;23(12):e30151. doi: 10.2196/30151.

DOI:10.2196/30151

PMID:34898455

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8713100/

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 a specialist for optimal health care management.

OBJECTIVE

The goal of the research is to determine whether video consultations are noninferior to face-to-face consultations in treating chronic headache patients referred to a specialist in Northern Norway.

METHODS

Patients included in the study were recruited from general practice referrals to a specialist at a neurological department in Northern Norway (Tromsø) and diagnosed according to the International Headache Society classification system. In a randomized controlled design, the 1-year remission rate of chronic headache (change from ≥15 to <15 headache days per month during the last 3 months), patient satisfaction with a specialist 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. 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 a specialist over 2.5 years, 58.0% (233/402) were classified as chronic headache and included in this study. Response rates were 71.7% (86/120) in the video group and 67.3% (76/113) in the face-to-face group. One-year remission from chronic headache was achieved in 43.0% (37/86) in the video group and 39.5% (30/76) in the face-to-face group (P=.38). Patient satisfaction with consultations were 86.5% (32/37; video) and 93.3% (28/30; face-to-face; P=.25). A total of 30% (11/37) in the video group and 53% (16/30) in the face-to-face group consulted general practitioners during the follow-up period (P=.03), and median number of consultations was 1 (IQR 0-13) and 1.5 (IQR 0-15), respectively (P=.19).

CONCLUSIONS

One-year remission rate from chronic headache was about 40% regardless of consultation form. Likewise, patient satisfaction with consultation and need for follow-up visits in general practice post consultation was 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.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02270177; https://clinicaltrials.gov/ct2/show/NCT02270177.

摘要

背景

慢性头痛会导致受疾病影响的患者出现严重的头痛相关残疾，但在许多情况下，这种疾病被漏诊或误诊，因此需要为患者提供便捷的途径，以便他们能够获得专家的最佳医疗保健管理。

目的

本研究旨在确定在挪威北部，视频咨询是否与面对面咨询一样，可用于治疗转介给专家的慢性头痛患者。

方法

研究对象为从挪威北部（特罗姆瑟）神经科的全科医生转介到专家的患者，并根据国际头痛协会分类系统进行诊断。采用随机对照设计，通过事后分析比较视频组和面对面组患者慢性头痛的 1 年缓解率（在过去 3 个月中每月头痛天数从≥15 天减少到<15 天）、患者对专家咨询的满意度以及全科医生随访咨询的需求。通过访谈（基线）和问卷调查（随访）收集数据。

结果

在 2.5 年的时间里，从连续转介到专家的 402 例头痛患者的基线队列中，58.0%（233/402）被归类为慢性头痛并纳入本研究。视频组的应答率为 71.7%（86/120），面对面组为 67.3%（76/113）。视频组的慢性头痛 1 年缓解率为 43.0%（37/86），面对面组为 39.5%（30/76）（P=.38）。视频组患者对咨询的满意度为 86.5%（32/37），面对面组为 93.3%（28/30）（P=.25）。视频组有 30%（11/37）的患者和面对面组有 53%（16/30）的患者在随访期间咨询了全科医生（P=.03），视频组和面对面组的中位数咨询次数分别为 1 次（IQR 0-13）和 1.5 次（IQR 0-15）（P=.19）。