{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T08:51:38Z","timestamp":1771663898731,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A survey was implemented for early assessment of pandemic\u2010related practice processes and quality improvement (QI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In response to the public health measures in Hawaii to curtail the coronavirus 2019 pandemic, Hawaii Pacific Neuroscience (HPN) adapted their patient care to ensure continuity of neurological treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The telephone survey was conducted on patients seen at HPN during the period of April 22, 2020\u2013May 18, 2020 to address four areas related to patients\u2019 outpatient experience: delivery of care, general well\u2010being, experience with telemedicine, and disease\u2010specific questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 928 patients were contacted of which 429 (46.2%) patients responded and 367 (85.5%) agreed to participate. A total of 133 patients with migraine and 234 patients with other neurological conditions provided responses. Our migraine patients\u2019 survey responses suggest that their well\u2010being was disproportionately negatively affected by the pandemic. Survey respondents with migraine were significantly more likely than their non\u2010migraine peers to report worsening anxiety and sleep problems [62\/132 (47.0%) vs. 78\/234 (33.3%),\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a06.64,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.010, and 64\/132 (48.5%) vs. 73\/234 (31.2%),\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a010.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001]; migraine patients also reported worsening of depression as a result of the pandemic more than patients with other diagnoses, though this was not statistically significant [44\/132 (33.3%) vs. 57\/234 (24.4%),\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a03.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.065]. In regard to access to healthcare, significantly more migraine patients reported running out of medications than those with other diagnoses [20\/133 (15.0%) vs. 18\/234 (7.7%),\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a04.93,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.026]. More avoided seeking medical help for new health problems because of the pandemic [30\/133 (22.6%) vs. 30\/234 (12.8%),\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a05.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015]. Migraine patients were also significantly impacted economically by the pandemic; 43\/132 (32.4%) of migraine patients reported losing their jobs as the result of the pandemic versus 34\/234 (14.5%) of their peers (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a011.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). An increase in headache severity or frequency was reported in 39\/118 (33.1%) of respondents and 19\/118 (16.1%) reported to using more abortive therapy than usual. Telemedicine was well received by almost all patients who took advantage of the option. Most of those patients found telemedicine to be easy to use and as valuable as an in\u2010person visit. Migraine patients indicated with more frequency that without the telemedicine option, they would have missed their medical appointments [37\/68 (54.4%) vs. 56\/144 (38.6%),\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a04.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.038]; a majority would prefer or consider telemedicine for future appointments over in\u2010person visits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Insights gained from this QI survey to the practice's new pandemic\u2010related processes include stressing lifestyle modification, optimizing treatment plans, and continuing the option of telemedicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14030","type":"journal-article","created":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T00:41:36Z","timestamp":1607992896000},"page":"149-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Early impact of the COVID\u201019 pandemic on outpatient migraine care in Hawaii: Results of a quality improvement survey"],"prefix":"10.1111","volume":"61","author":[{"given":"Maiya","family":"Smith","sequence":"first","affiliation":[{"name":"John Burns School of Medicine University of Hawaii Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Nakamoto","sequence":"additional","affiliation":[{"name":"John Burns School of Medicine University of Hawaii Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Crocker","sequence":"additional","affiliation":[{"name":"John Burns School of Medicine University of Hawaii Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Tiffany Morden","sequence":"additional","affiliation":[{"name":"John Burns School of Medicine University of Hawaii Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keke","family":"Liu","sequence":"additional","affiliation":[{"name":"John Burns School of Medicine University of Hawaii Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enze","family":"Ma","sequence":"additional","affiliation":[{"name":"John Burns School of Medicine University of Hawaii Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Chong","sequence":"additional","affiliation":[{"name":"Undergraduate Education University of Hawaii at Manoa Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Van","sequence":"additional","affiliation":[{"name":"Undergraduate Education University of Hawaii at Manoa Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vimala","family":"Vajjala","sequence":"additional","affiliation":[{"name":"Headache &amp; Facial Pain Center Hawaii Pacific Neuroscience Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Carrazana","sequence":"additional","affiliation":[{"name":"Clinical Research Center Brain Research, Innovation &amp; Translation Labs Hawaii Pacific Neuroscience Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Viereck","sequence":"additional","affiliation":[{"name":"Clinical Research Center Brain Research, Innovation &amp; Translation Labs Hawaii Pacific Neuroscience Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kore","family":"Liow","sequence":"additional","affiliation":[{"name":"Clinical Research Center Brain Research, Innovation &amp; Translation Labs Hawaii Pacific Neuroscience Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"COVID\u201019 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University","author":"Johns Hopkins University School of Medicine","year":"2020"},{"key":"e_1_2_10_3_1","unstructured":"https:\/\/health.hawaii.gov\/coronavirusdisease2019\/. 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