A pilot health care programme for patients with migraine by means of a telemedicine-teleconsultation system in daily clinical practice

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. To present a health care system for patients with migraine in which both primary care and Neurology services work together using the new technologies. 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. 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. 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.