Telehealth Increases Access to Brief Behavioral Interventions in an Orofacial Pain Clinic During the COVID-19 Pandemic: A Retrospective Study

Objective: The aim of the study was to test whether patients with orofacial pain were more likely to start and complete a brief psychological intervention for managing certain chronic orofacial pain conditions (physical self-regulation [PSR]) via telehealth (during the COVID-19 pandemic) vs. in-person (before the COVID-19 pandemic). The exploratory aim was to describe demographic factors that could influence patients' likelihood of starting and completing PSR. Methods: Retrospective medical charts of all patients seen at a university-affiliated tertiary orofacial pain clinic between July-December 2019 (in-person; before the pandemic) and July-December 2020 (telehealth; during the pandemic) were reviewed. Charts were examined for demographic information and to compare the number of patients who started and completed PSR during each study period (chi-squared test). Results: Of 248 new patients seen in the clinic during the 2019 period, 25 started PSR in-person (10.08%). Of 252 new patients seen during the 2020 period, 53 started PSR via telehealth (21.03%). Patients were more likely to start PSR (odds ratio = 6.21, p < 0.001, 95% confidence interval = 2.499 to 15.435) and more likely to complete all three sessions of PSR (odds ratio = 5.69, p < 0.001, 95% confidence interval = 2.352 to 13.794) when it was offered via telehealth than when it was offered in-person. Among those who started PSR via telehealth, patients from metropolitan areas were more likely to start the intervention than those from non-metropolitan areas (p = 0.045). Conclusions: Offering brief psychological pain interventions via telehealth in tertiary orofacial pain clinics has demonstrated feasibility and may improve patients' willingness to participate in psychological treatments. Results need to be replicated with prospective data, as modality was confounded with the pandemic in the present study.