Towards eHealth to support the health journey of headache patients: a scoping review

DOI: https://doi.org/10.1007/s00415- 020- 09981- 3

Abstract-Summary The aim of this study is to (1) review the digital health tools that have been used in headache studies, and (2) discuss the effectivity and reliability of these tools.

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eHealth, mHealth, and digital therapeutic modalities have been advocated as the

way forward to improve patient care.

Digital (cognitive) behavioral therapy were also quite common (N = 7 out of 39). Other digital health tool categories were tele-consultations, telemonitoring and

patient portals.

Many digital health tools for headache patients regarding diaries and behavioral/ therapeutical treatment are described in scientific research with limited information on effectivity and reliability.

Scientific knowledge with regard to other categories such as tele-consultations, patient portals, telemonitoring including medication adherence, online information resources, wearable, symptom checkers, digital peer support is still scarce or missing.

Extended: Other digital health tool categories were tele-consultations (N = 4 out of 39), telemonitoring (medication adherence) (N = 2 out of 39) and patient portal (patient-doctor) (N = 2 out of 39).

The following information categories were used from each study: digital health tool category, author, year, country/countries, tool name, operating system, manu- facturer/vendor/developer, description of the tool, study design, participant charac- teristics in studies (sample size, age, and gender), headache type, and primary outcome.

Introduction With the pressing demand on the health care system, a shift towards the use of eHealth, mHealth, and digital therapeutic modalities has been advocated as the way forward to improve patient care and provide support to larger (underserved) groups of patients [344, 345].

As compared to traditional approaches, where patients have to visit the out- patient clinic for diagnosis and treatment, eHealth enabled care is about reducing the number of in-person visits while at the same time getting more (accurate) infor- mation from the patients via remote devices [346].

With respect to headache treatment and management, the use of eHealth applica-

tions or digital therapeutics has also been advocated.

Due to the many (fast) developments in eHealth, it is largely unknown which eHealth tools are available and, more importantly, also effective in the treatment of headache patients.

Method Online databases PubMed, Cinahl, and PsycINFO were searched to retrieve research studies concerning digital health tools for headache patients.

Hand search was performed screening the references of included articles and

previous review paper.

Two authors (DG and GS) screened all articles as studies independently based on title and abstract using Covidence and made a selection of articles for full text screening.

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Articles that involved a review were not included in this study, though their ref- erenced articles were checked for presence in our search results, and hand-selected if absent.

The following information categories were used from each study: digital health tool category, author, year, country/countries, tool name, operating system, manu- facturer/vendor/developer, description of the tool, study design, participant charac- teristics in studies (sample size, age, and gender), headache type, and primary outcome.

Results Since 2015, the number of studies related to digital health tools for headache patients increased.

The studies included 94,127 participants. In four studies, males were not included at all. Other types of headache were examined by 25 studies, including medication-

overuse headache and non-acute headache.

Two articles included a formative usability evaluation (pilot) study. The majority of studies focused on diaries (N = 27 out of 39). One study examined a headache training tool for specialists. In 17 studies, the operating platform was not mentioned. According to the evaluated studies, using an electronic headache diary seems to contribute to a more clear diagnosis, better assessment of headache burden, and accurate medication use and therapy response.

Besides headache diaries, a significant number of studies (N = 7 out of 39) has reported the results of online behavioral interventions aiming to reduce the head- ache burden.

Discussion Headache app can support the health journey of headache patients in several ways like providing digital headache education, diary keeping, classifying headache attacks, and keeping track of medication adherence.

We would encourage more research and implementation effort in understanding patient use of online information resources for their headache complaints, symptom checkers, digital peer support, remote tele monitoring, the collection and analysis of patient reported outcome metrics (PROMs) in therapy and the use of wearables in collecting data on disease burden and lifestyle.

Future research regarding other digital health tool categories than dairies and behavioral/therapeutical treatment is needed, namely tele-consultations, patient portals, telemonitoring including medication adherence, online information resources, symptom checkers, digital peer support, telemonitoring including proms and telemonitoring including wearables.

Many digital health tools for headache patients regarding diaries and behavioral/

therapeutical treatment are described in scientific research.

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Key Findings Scientific research regarding eHealth for headache patients mainly described elec- tronic diaries and behavioral or therapeutical treatments.

Future eHealth studies should focus on the benefits and clinometric properties of

these tools.

Outcome measures preferably include validated headache and migraine outcome

parameters to increase generalizability across studies.

Acknowledgement A machine generated summary based on the work of van de Graaf, Daniëlle L.; Schoonman, Guus G.; Habibović, Mirela; Pauws, Steffen C. 2020  in Journal of Neurology.

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