Objectives/background: The objectives were to determine patients' interest in and reluctance to use teleconsultation, to assess the feasibility of teleconsultation from the physician's perspective, to identify criteria that predict the acceptability of teleconsultation, and to calculate the carbon footprint in kilograms of carbon dioxide equivalent (kg CO₂e). Headache is a common disorder, and about 1% of patients with headache need to be seen in tertiary headache centers, sometimes geographically distant. Teleconsultation is an interesting option for monitoring patients.

Methods: An observational, cross-sectional, and anonymous survey was conducted among patients attending a French tertiary headache center between November 1, 2023 and January 31, 2024.

Results: The questionnaires of 1070 patients (74.2%) were analyzed. Patients were open to the use of teleconsultation in 70.8% of cases and reluctant in 28.6%. Physicians indicated that the consultation could have been performed by teleconsultation in 84.3% of cases. We highlighted certain characteristics of patients who preferred teleconsultation, including an estimated visit time of >1 hour, being between the ages of 25 and 54 years, having had previous teleconsultations, and taking time off work. Approximately 19,917 kg CO₂e were generated by patient transport, with an estimated median per patient of 7.8 kg CO₂e (interquartile range, 1.4-24).

Conclusion: Teleconsultation for headache management is desired by the majority of patients and is usually feasible from the physician's perspective. Age, travel time, time off work, and previous experience with teleconsultation influence the desire for teleconsultation. This study shows the significant carbon footprint generated by patient transport for headache consultations. Numerous studies have demonstrated that teleconsultations provide the same quality of care as in-person consultations for headache management, while improving access to care. Increased use of teleconsultation seems ideal for maintaining high-quality care while reducing CO₂e emissions related to transportation.