Hospital-based headache care during the Covid-19 pandemic in Denmark and Norway

J Headache Pain. 2020 Oct 29;21(1):128. doi: 10.1186/s10194-020-01195-2.

Abstract

Background: The Covid-19 pandemic is causing changes in delivery of medical care worldwide. It is not known how the management of headache patients was affected by the lockdown during the pandemic. The aim of the present study was to investigate how the initial phase of the Covid-19 pandemic affected the hospital management of headache in Denmark and Norway.

Methods: All neurological departments in Denmark (n = 14) and Norway (n = 18) were invited to a questionnaire survey. The study focused on the lockdown and all questions were answered in regard to the period between March 12th and April 15th, 2020.

Results: The responder rate was 91% (29/32). Of the neurological departments 86% changed their headache practice during the lockdown. The most common change was a shift to more telephone consultations (86%). Video consultations were offered by 45%. The number of new headache referrals decreased. Only 36% administered botulinum toxin A treatment according to usual schemes. Sixty% reported that fewer patients were admitted for in-hospital emergency diagnostics and treatment. Among departments conducting headache research 57% had to halt ongoing projects. Overall, 54% reported that the standard of care was worse for headache patients during the pandemic.

Conclusion: Hospital-based headache care and research was impacted in Denmark and Norway during the initial phase of the Covid-19-pandemic.

Keywords: CGRP; General population; Health care planning; Migraine; SARS-CoV-2; Telemedicine.

MeSH terms

  • Betacoronavirus
  • Botulinum Toxins, Type A / therapeutic use
  • COVID-19
  • Cluster Headache / diagnosis
  • Cluster Headache / therapy
  • Coronavirus Infections*
  • Delivery of Health Care*
  • Denmark
  • Disease Management
  • Headache / diagnosis
  • Headache / therapy
  • Headache Disorders / diagnosis
  • Headache Disorders / therapy*
  • Hospital Departments
  • Hospitalization / statistics & numerical data
  • Humans
  • Migraine Disorders / diagnosis
  • Migraine Disorders / therapy
  • Neurology*
  • Neuromuscular Agents / therapeutic use
  • Norway
  • Outpatient Clinics, Hospital
  • Pandemics*
  • Pneumonia, Viral*
  • Referral and Consultation
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Telecommunications / statistics & numerical data
  • Telemedicine / statistics & numerical data*
  • Videoconferencing / statistics & numerical data

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A