Video consultation for non-acute headache by neurologist is not inferior to traditional consultations in terms of headache consultation rate at follow-up: post hoc analyses of a randomized controlled trial

OBJECTIVE: To investigate whether use of video consultations at neurologist for patients with new non‐acute headache are noninferior to face‐to‐face consultations in the need for subsequent headache consultations or hospitalizations. METHODS: This study is based on post hoc analyses from data collected at baseline consultations (n = 402) and by questionnaires at 12‐month follow‐up (n = 291) in a randomized controlled non‐inferiority efficacy and safety trial. The study is conducted in a combined rural and urban area where neurological service is centralized to one hospital. Rate of patients consulting neurologist for headache or being hospitalized for headache during 12‐month follow‐up were compared between groups consulted by video and face‐to‐face. Secondarily, follow‐up headache visits in general practice were investigated by questionnaire. RESULTS: Rates of patients in the video group (n = 22; 16.8%) and the face‐to‐face group (n = 24; 18.5%) who consulted neurologist or were hospitalized for headache the next 12 months after baseline consultations were statistically indifferent, CI [0.637, 2.273], (p = 0.752). Median (IQR range) number of consultations or hospitalizations were 0 (IQR: 0‐5) respectively 0 (IQR: 0‐6), p = 0.421. Rates of patients visiting general practitioners (GPs) for headache during 12‐month follow‐up were 89 (63.1%) respectively 92 (69.2%), p = 0.309. Median (IQR range) were 1.0 (0‐15) and 1.0 (0‐15), p = 0.156. Sex, age, waiting time to specialist, renewed headache diagnosis and initiation of medical treatment by specialist were equally distributed between the groups. No secondary headache or underlying medical conditions were detected in any group. CONCLUSION: Acknowledging the methodological limitation of the post hoc design, these data give evidence to the view that use of video in headache treatment at specialist contribute to better health service efficiency by providing availability to care for these patients. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov, identifier NCT02270177.