Abstract Details

Title Asynchronous Telemedicine Platform Associated with Decreased Migraine-Related Emergency Room and Urgent Care Use

Topic Headache

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-006

Objective To describe the change in patient-reported emergency room (ER) and urgent care centers (UCC) use before and after patients joined a migraine telemedicine platform.

Background ERs are suboptimal for migraine care given long wait times, high costs, and the administration of non-evidence based treatment including opioids. While UCCs may be preferred to ERs due to lower costs, there are similar quality issues. Access to ongoing care models, including telemedicine-based approaches, may result in decreased migraine-related ER and UCC use, collectively called emergent healthcare resource use (EHRU).

Design/Methods Patients receiving care from the novel migraine telemedicine platform, Cove, have access to on-demand asynchronous evidence-based consultation, ongoing messaging, and e-pharmacy. Data from patients completing the headache-focused intake questionnaire and an outcomes-based follow-up questionnaire at 3-months were analyzed. Data collected included demographics, EHRU, treatment type, and patient satisfaction. Statistical differences in patient-reported EHRU in the 3-months before and after joining the telemedicine platform were assessed using McNemar’s test.

Results

Data from 4,789 patients who completed the intake and follow-up questionnaire were analyzed. The median age was 38 years (range: 18-85 years), 90% were female, and 15% were Black, indigenous, and/or people of color.

Patients experienced reduced migraine-related EHRU between intake and follow-up. At intake, 4.8% of patients reported an ER visit and 7.0% reported an UCC visit in the prior 3 months. At follow-up, only 2.1% of patients reported an ER visit (55.3% reduction, p<.01) and 3.8% an UCC visit (45.7% reduction, p<.01) in the prior 3 months.

After joining the telemedicine platform, 91.8% received acute and 52.6% received preventive medications. No patients were prescribed opioids through the platform.

At follow-up, 90.6% of patients were satisfied with the care received.

Conclusions Telemedicine platforms may contribute to reduced EHRU in patients with migraine, and provide access to evidence-based migraine care including the avoidance of opioid-based treatments.

Authors/Disclosures
Sara C. Crystal, MD (NY Headache Center) PRESENTER	Dr. Crystal has received personal compensation for serving as an employee of Thirty Madison. Dr. Crystal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Crystal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Alexander A. Mauskop, MD, FAAN (New York Headache Center)	Dr. Mauskop has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Allergan. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lily. Dr. Mauskop has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Alan M. Rapoport, MD, FAAN	Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie, Amgen, Biohaven, Cala Health, Satsuma, Teva Pharmaceutical Industries, Theranica, Xoc and Zosano. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie, Amgen, Biohaven, Lundbeck and Teva Pharmaceutical Industries. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews.
Robert Cowan, MD, FAAN (Stanford Neurosciences Health Center)	Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for lundbeck. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biohavenn. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbviie. Dr. Cowan has stock in Percept. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received publishing royalties from a publication relating to health care.
	No disclosure on file
Jessica Kiarashi, MD (UT Southwestern Medical Center)	Dr. Kiarashi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for COVE.
	No disclosure on file
Adam B. Cohen, MD (Massachusetts General Hospital)	Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Thirty Madison. Dr. Cohen has received stock or an ownership interest from Thirty Madison.
	No disclosure on file

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