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Abstract Details

The Impact of Telehealth During the COVID-19 Pandemic on the Clinical Evaluation and Outcome of Headache in Children and Adolescents
Headache
P7 - Poster Session 7 (8:00 AM-9:00 AM)
15-005
To assess whether telehealth initial evaluations show a difference in ordering imaging, headache management, and disease outcomes, as compared to in-person initial evaluations.
For many patients with headache, telehealth provides greater access to care and reduced travel costs; however, the risks or benefits of telehealth for initial neurology visits has not been previously studied.
In this retrospective review, initial and follow-up visit data was pulled from the Cincinnati Children’s Hospital Headache Center database and chart review, with initial telehealth visits between March 2020 and March 2021. Patients in the in-person control group were matched by age, sex, race, and visit days within 100 days. At initial visit, image ordering, imaging findings, and diagnosis were measured. At initial and first follow up visit, average headache severity, frequency, duration, PedMIDAS scores, and healthy habits were measured. Patients were split into 6 groups by their visits: Telehealth/Telehealth, Telehealth/In-Person, Telehealth/None, In-person/In-person, In-person/Telehealth, and In-person/None.
Of the initial telehealth group (n=652) 53% had imaging ordered, against 39% from the initial in-person group (n=801) (P<0.01). At initial visit, Tele/None mean PedMIDAS score was 33.5 (95% CI, 28.2-38.8), whereas In-Person/None was 45.4 (95% CI, 40.6-50.2) (P<0.01). Tele/Tele mean PedMIDAS score was 39.5 (95% CI, 33.9-45.1), whereas In-Person/Tele was 50.7 (95% CI, 42.2-59.1) (P<0.05). 405 telehealth patients and 374 control patients had a follow-up visit. At first follow-up visit, Tele/In-person patients had an average reduction in PedMIDAS scores of 5.6 (95% CI, -0.8-12.0), whereas In-person/In-person patients had a reduction of 15.8 (95% CI, 8.6-23.0) (P<0.05).

Telehealth visits showed more imaging but similar outcomes. The initial telehealth group had lower initial PedMIDAS scores; initial in-person visits showed a greater reduction in PedMIDAS scores. There was no significant difference between initial telehealth groups and initial in-person groups in change in average severity or frequency.
Authors/Disclosures
Michaela Reuter, MD (Reuter)
PRESENTER 		The institution of Ms. Reuter has received research support from 好色先生.
Tate Reuter Mr. Reuter has nothing to disclose.
No disclosure on file
Andrew D. Hershey, MD, PhD, FAAN, FAHS, FAAN The institution of Dr. Hershey has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. The institution of Dr. Hershey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. The institution of Dr. Hershey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus. The institution of Dr. Hershey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Upsher-Smith. The institution of Dr. Hershey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. The institution of Dr. Hershey has received research support from Amgen. The institution of Dr. Hershey has received research support from NIH, NINDS. The institution of Dr. Hershey has received research support from Bioahaven. The institution of Dr. Hershey has received research support from Upsher-Smith. Dr. Hershey has received publishing royalties from a publication relating to health care.
Marielle K. Samaha, MD, FAHS, FAAN, FAAN (Cincinnati Children's Hosp Medl Ctr) Dr. Samaha has received personal compensation in the range of $500-$4,999 for serving as a Consultant for theranica. Dr. Samaha has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for AAN . The institution of Dr. Samaha has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for AAP. Dr. Samaha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for theranica.