Evaluation of the contribution of a mobile app/telemedicine system Dr Cefaleia in the diagnosis and treatment of primary headache patients

• Grant number: 19/22403-6
• Support Opportunities: Research Grants - Innovative Research in Small Business - PIPE
• Start date: August 01, 2020
• End date: April 30, 2021
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Renan Barros Domingues
• Grantee: Renan Barros Domingues
• Company: Doutor Cefaleia Serviços Médicos e de Telemedicina Eireli
• CNAE: Atividades de atenção ambulatorial executadas por médicos e odontólogos ; Atividades de serviços de complementação diagnóstica e terapêutica
• City: São Paulo
• Associated researchers: João Henrique Sass de Souza
• Associated scholarship(s): 20/12858-3 - App review Dr Cefaleia, BP.TT; 20/11398-9 - Graphic and digital development of the Dr Cefaleia app, BP.TT

Abstract

The primary headaches are very common, being reported by more than 50% of the adult population (Domingues ecols., 2004). Nearly 30% of the sufferers would need a prophylactic treatment, but not more than 20% have access to this modality of treatment in Brazil (Corrêa ecols., 2010). The barriers to treatment access include the lack of qualified professionals and the self-medication culture. The absence of a proper treatment results in headache worsening, chronification, and increased individual and social headache impact (Bigal e Lipton, 2011). These factors affect quality of life and leading to absenteeism and presenteeism (Leonardi e Raggi, 2019). According to the Global Burden of Diseases, migraine is the second neurological disease in terms of disability, being the most cause of living with disability in subjects aged less than 50 years. Therefore, there is a clear need of improving the access to prophylactic treatments in Brazil, even with a limited number of headache specialists in our country. The "Dr Cefaleia" system was developed aiming to improve the access to scientifically validated treatments for the headaches, employing a digital technology system. The system includes an app (Dr Cefaleia) already available in GoogleStore and AppStore. The patient make a his registration and then he/she fills a series of validated questionnaires (a process we call Journey) about headache features and the main comorbidities, including sleep disorders, anxiety and depression. The results are processed by out algorithms thus generating diagnostic and therapeutic suggestions. These suggestions appear in the patient chart in the doctor's (spoke) web interface. This system is already available and has already been presented in scientific meetings and submitted to publication. The aims of the present project are: a) develop a telemedicine platform inside the app, allowing synchronous communication between patient and doctor, b) develop a spoke -hub telemedicine synchronous system; c) carry out a clinical study for evaluating the feasibility of the system, in terms of satisfaction and efficiency. After demonstrating the Dr Cefaleia system feasibility and efficiency we intend to launch the new functionalities of the app, and largely publicizing it to potential users. The system may add value for patients (accessible treatments) and physicians (by adding expertise and providing a safe communication system). Taking into account the prevalence data there is currently a deficit of >3.000.000 headache consultations per month. The Dr Cefaleia intends to initially reach 3% of this market, potentially generating monthly revenue of R$ 1-2k. We also believe that this system can be incorporated as a public health tool, contributing to the reduction of the waiting time for neurological consultations, since headaches represent 40% of the outpatient care. Above all, this system was designed to minimize the burden of headaches in our society, reducing absenteeism and presenteeism, and improving the quality of life of sufferers. (AU)