[A pilot health care programme for patients with migraine by means of a telemedicine-teleconsultation system in daily clinical practice]. / Programa piloto de atencion a pacientes con migrana a traves de un sistema de telemedicina-teleconsulta en la practica clinica diaria.

INTRODUCTION: Migraine is a very frequent pathology that affects young people; it is a common reason for visits to Neurology outpatient services and a burden on health care services. In Extremadura it causes important movements due to the geographical dispersion that exists in the region. AIM: To present a health care system for patients with migraine in which both primary care and Neurology services work together using the new technologies. PATIENTS AND METHODS: Real time teleconsultation for patients with migraine who need neurological care, by contacting primary care centres that are more than 50 km away from the referral hospital. RESULTS: One year after the system started operating, 13 teleconsultations have been made, with a total of 41 patients being evaluated, 78% of whom were females. The reasons for seeking neurological care were: treatment was not effective (51%), confirmation of diagnosis (22%), change in the clinical features (17.1%), increased frequency or intensity of seizures (5%), onset of migraine (2.4%) and not specified (17%). The neurologist conducted a structured interview, with the aid of the primary care team, and a clinical report was drawn up with a proposal for treatment following the usual clinical praxis. Cases that did not fit the protocol were referred to the traditional model of care. CONCLUSIONS: A programme that is developed in accordance with the first level of health care for these patients, by means of a telematic system, allows them to be evaluated without the need to travel to a hospital and favours the relationship between the two levels of health care.

Programa piloto de atención a pacientes con migraña a través de un sistema de telemedicina-teleconsulta en la práctica clínica diaria / A pilot health care programme for patients with migraine by means of a telemedicine-teleconsultation system in daily clinical practice

Introducción. La migraña es una patología muy frecuente que afecta a personas jóvenes; es motivo habitual de consulta ambulatoria en Neurología y de sobrecarga asistencial. En Extremadura causa notables desplazamientos por la dispersión geográfica existente. Objetivo. Presentar un sistema de atención compartido entre atención primaria y Neurología en pacientes con migraña utilizando las nuevas tecnologías. Pacientes y métodos. Teleconsulta en tiempo real a pacientes con migraña que precisen atención neurológica, conectando con centros de atención primaria alejados del hospital de referencia más de 50 km. Resultados. Al año de la puesta en marcha de este sistema se han realizado 13 teleconsultas, evaluándose 41 pacientes, 78% mujeres. Los motivos de atención neurológica han sido: falta de eficacia del tratamiento (51%), confirmación diagnóstica (22%), cambio en las características clínicas (17,1%), aumento en la frecuencia o intensidad de las crisis (5%), inicio migrañoso (2,4%) y sin especificar (17%). Se realizó una entrevista estructurada por parte del neurólogo, con el apoyo del equipo de primaria y un informe clínico con una propuesta de tratamiento siguiendo la práctica clínica habitual. Se remitieron al modelo de atención tradicional los casos no ajustados al protocolo. Conclusiones. Un programa consensuado con el primer nivel asistencial de atención a estos pacientes permite, a través de un sistema telemático, su valoración evitando el desplazamiento al hospital y favoreciendo la relación entre ambos niveles asistenciales

Introduction. Migraine is a very frequent pathology that affects young people; it is a common reason for visits to Neurology outpatient services and a burden on health care services. In Extremadura it causes important movements due to the geographical dispersion that exists in the region. Aim. To present a health care system for patients with migraine in which both primary care and Neurology services work together using the new technologies. Patients and methods. Real time teleconsultation for patients with migraine who need neurological care, by contacting primary care centres that are more than 50 km away from the referral hospital. Results. One year after the system started operating, 13 teleconsultations have been made, with a total of 41 patients being evaluated, 78% of whom were females. The reasons for seeking neurological care were: treatment was not effective (51%), confirmation of diagnosis (22%), change in the clinical features (17.1%), increased frequency or intensity of seizures (5%), onset of migraine (2.4%) and not specified (17%). The neurologist conducted a structured interview, with the aid of the primary care team, and a clinical report was drawn up with a proposal for treatment following the usual clinical praxis. Cases that did not fit the protocol were referred to the traditional model of care. Conclusions. A programme that is developed in accordance with the first level of health care for these patients, by means of a telematic system, allows them to be evaluated without the need to travel to a hospital and favours the relationship between the two levels of health care