Headache relevance in outpatient activity during Covid-19 pandemic
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Headache relevance in outpatient activity during Covid-19 pandemic Francesca Gatti 1 & Letizia Manneschi 1
# Fondazione Società Italiana di Neurologia 2020
Nowadays headache disorders represent a great impact on the sanitary system, and in fact the WHO currently reports that the worldwide prevalence among adults of current headache disorder is estimated to be around 50%; moreover, in Global Burden of Disease Study, headache disorders collectively were reported as the third highest cause of years lost due to disability. The most common headache disorders are migraine, tension-type headache (TTH) and trigeminal autonomic cephalalgias (TACs). Moreover, in many recent studies, headache is reported as one of the most frequent admitting symptoms to the emergency department, even if it has been well stated that the ED is a suboptimal place for headache treatment, suggesting that an urgent admission to a headache centre should be preferred even in the acute headache attacks [1]. At the beginning of the year 2020, with the spread of the Covid-19 pandemic, we observed major changes in the way we used to deliver primary care services: In fact, since March, many structures have been readdressed in SARS-COV-2 hospitals and all emergency department accesses were reserved for Covid-19 patients. Also, all non-urgent outpatient activities in Italy were suspended, meaning that headache centres could not deliver any service. In this context, we would like to report our recent experience. Fidenza is a middle-sized town in northern Italy, in the third Italian region for total number of Covid-19 infection cases; the healthcare district of Fidenza gathers a total population of approximately 100,000 people and refers to the main hospital of Fidenza-Vaio. During the Covid-19 pandemic, this hospital was soon converted to a Covid-19only structure and the headache centre was closed, as well as all other neurologic outpatient activities. In this situation, a space dedicated only to urgent outpatient consults (up to 10 days) was created.
* Francesca Gatti [email protected] 1
Dipartimento Cure Primarie, Distretto di Fidenza, Ausl Parma, Via don E. Tincati, 5, 43036 Fidenza (PR), Italy
To assure maximum safety to all the patients and to prosecute the continuity of care, the use of telemedicine was soon implemented, including both phone calls and video calls, in order to provide assistance to the largest possible number of patients minimizing the hospital accesses. The need for social distancing has been witnessed all over the world, and in fact some studies already report their successful experience in teleneurology, due to the urgent need to continue to deliver outpatient care, and focus on the fact that this use of instruments has the potential to fulfil the gap created by the pandemic crisis [2]. In our experience of neurological urgent outpatient activity during the Covid-19 pandemic, in nearly 3 months, from 9 March to 20 May 2020, with a mean of 7.1 required consults per week in the whole district of Fiden
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