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Abstract Details

Direct-To-Consumer Asynchronous Telemedicine as a Solution to Improve Health Access for Underrepresented Minorities in Migraine Care
Headache
P11 - Poster Session 11 (11:45 AM-12:45 PM)
15-001
Health and healthcare disparities related to race and ethnicity adversely affect patients with migraine. Telemedicine-based approaches to migraine management may improve these disparities.
To describe baseline migraine severity, treatment, and migraine-related healthcare utilization in patients of different races and ethnicities who joined a novel migraine telemedicine platform.
This study examined patients who self-enrolled in a direct-to-consumer migraine telemedicine platform, Cove, which utilizes asynchronous evidence-based consultation, continuous patient-reported monitoring metrics, and e-pharmacy. Data from the headache-focused intake questionnaire was analyzed across race/ethnicity groups (white-only versus underrepresented minority race/ethnicity [Hispanic/Latino, Black, Asian, American Indian, Other, Multiple Races]).

A total of 2,068 patients (90% female, average age 38 years) were analyzed. Regarding race/ethnicity, 1,673 (81%) patients identified as white-only and 395 (19%) patients identified as a minority race/ethnicity (Hispanic/Latino [9%], Black [5%], Asian [4%], American Indian [2%], Other [1%]). 

White-only patients and minority patients had the same mean number of monthly headache days (11 days); the latter reported more intense headaches on a 10-point scale (8 vs. 7, p-value: <.01). 

Prior to joining the telemedicine platform, minority patients, relative to white-only patients, were less likely to have received any treatment (acute or preventive) for their migraine (84% versus 89%, p-value: .03), and the disparity was more pronounced for preventive treatments (30% versus 38%, p-value: <.01). Underrepresented patients were also less likely to have seen a primary care provider or neurologist for their migraine care before joining the telemedicine platform (77% vs. 83%, p-value: <.01).
Minority patients in this study population previously had less contact with health care providers and less migraine treatment; telemedicine platforms may contribute to a reduction in health access disparities. Such care models may improve care for underrepresented migraine patients by increasing access to evidence-based migraine care and treatment.
Authors/Disclosures
Sara C. Crystal, MD (NY Headache Center)
PRESENTER 		Dr. Crystal has received personal compensation for serving as an employee of Thirty Madison. Dr. Crystal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Crystal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Alexander Mauskop, MD, FAAN (New York Headache Center) Dr. Mauskop has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Allergan. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lily. Dr. Mauskop has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Mauskop has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Alan M. Rapoport, MD, FAAN Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie, Amgen, Biohaven, Cala Health, Satsuma, Teva Pharmaceutical Industries, Theranica, Xoc and Zosano. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie, Amgen, Biohaven, Lundbeck and Teva Pharmaceutical Industries. Dr. Rapoport has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews.
Robert Cowan, MD, FAAN (Stanford Neurosciences Health Center) Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for lundbeck. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biohavenn. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbviie. Dr. Cowan has stock in Percept. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received publishing royalties from a publication relating to health care.
No disclosure on file
No disclosure on file
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No disclosure on file
Adam B. Cohen, MD (Massachusetts General Hospital) Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Thirty Madison. Dr. Cohen has received stock or an ownership interest from Thirty Madison.
No disclosure on file