Effect of video consultation for non-acute headache by neurologist on consultation rate in general practice during one-year follow-up. Randomized controlled trial

Abstract Background Patient´s access to headache specialists varies in the population. Video consultations may help, but the effect of using communication technology on headache management in the population is incompletely understood. This study determined whether use of video consultations for non-acute headache patients at specialist were noninferior to face-to-face consultations in the need for subsequent headache visits in general practice at follow-up. Methods Four hundred and two non-acute headache patients consecutively referred to neurologist from general practitioners in North Norway were included in a randomized controlled noninferiority trial. Frequency of patients consulting general practitioner for headache and median number of headache consultations 0–12 months after specialist consultation were compared between groups initially consulted by video or face-to-face consultations. Results Ninety-two (60.9%) of the patients in the video group and 93 (66.4%) in the face-to-face group consulted general practitioners for headache problems during the follow-up period, p = 0.274. The median (IQR range) number of consultations were 1 (IQR: 0–14) (video) and 1 (IQR: 0–15) (face-to-face), p = 0.154. Clinical characteristics including, headache impact, pain score and patients satisfied with headache information, communication, headache advice, diagnostic information, and headache medication at GP during follow-up were similar between the two groups. Conclusion Treating headache patients by using video consultations at neurologist did not result in higher consultation rate at follow-up in general practice. These data support use of video as a useful method in the treatment of headache at specialist in terms of organization of headache management in the population. Trial registration: Trial registration number NCT02270177. Registration date: October 2, 2014