Feasibility and Efficacy of Telephone Based Follow-up in Patients with Headache - A Longitudinal Cohort Study

Background: Chronic headache greatly affects the quality of life and also constitutes a significant burden on the health system. Objective: The objective of this study was to evaluate the feasibility of telephone-based follow-up in a cohort of headache patients in India. Materials and Methods: This was a longitudinal cohort study of patients with episodic headache with one physical visit in the neurology outpatient services in the last year. Two neurologists conducted the telephone follow up (TFU) of included patients 12 weeks apart. We evaluated the following: (1) objective characterization of headache, (2) coexistent depression and anxiety, (3) patient satisfaction, (4) treatment adherence, and (5) changes in medications. Results: A total of 214 out of 274 eligible patients were included in the cohort. The mean age was 31.74 +/- 7.77 years (18-45), and 164 (77%) were females. Migraine without aura was the most common diagnosis in 159 (74%). The mean disease duration was 78.01 +/- 70.15 months (8-360). Concurrent depression and anxiety were noted in 87 (40.6%) and 45 (21%) of the patients, respectively. There was a significant improvement in the headache frequency (23.82 vs. 1.06, P < 0.001), severity (7.21 vs. 2.62, P = 0.032), and Headache Impact 6-item score (58.12 vs. 38.01, P = 0.014) at baseline and second follow-up. The satisfaction level to TFU in the first and second interviews was 94.4% and 97.2%, respectively. Conclusion: Telephone-based follow-up is a feasible alternative for repeat outpatient consultation of headache patients.