Tailored Messaging and Behavioral Treatment for Migraine

Saint Louis University, Saint Louis MO

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): This K23 Career Award application combines a training and research plan. Training Plan: The candidate's long-term career goal is to establish a programmatic line of research investigating ways to enhance the effectiveness of behavioral treatments for migraine. In order to accomplish this long-term goal, is it critical to obtain advanced training in: 1) designing, implementing, and evaluating clinical trials;2) effective behavioral and pharmacologic treatment for migraine;and 3) using tailored messaging approaches in behavioral treatments for health related disorders. Training will take place under the guidance of a mentorship team with expertise in these areas. Short-term goals will be met through a combination of formal coursework, directed readings, hands-on experiential training, professional seminars and workshops, and meetings with the primary and co-mentors. Research Plan: Nearly 20% of households in the United States have someone who suffers from migraine headache. Behavioral treatments are a first-line option for migraine prevention;however, <5% of migraine sufferers utilize behavioral treatments. Self-administered behavioral treatments have the promise of greater dissemination;however, they are typically mass-produced and cannot provide personalized feedback that is more likely to trigger change. Tailored messaging can make self-administered behavioral treatment for migraine prevention personally relevant and, thus, in theory, be more efficacious than generic self administered, behavioral treatment. Preliminary findings from a pilot study conducted by the PI indicate that a Tailored Behavioral Strategies for Preventing Migraine (TABS-PM) treatment may be an efficacious self administered behavioral treatment for migraine prevention. The research portion of this K Award seeks to extend this line of research by conducting a randomized controlled trial (RCT) evaluating the efficacy of TABS-PM + usual care relative to generic behavioral strategies for preventing migraine (GBS-PM) + usual care or to usual care alone. The RCT will recruit 84 primary episodic migraine sufferers from a large primary headache center. The primary outcome will be change in the number of headache days per month from baseline to post-treatment (assessed daily using the Experience Sampling Program software installed on Palm handheld devices for a 4-week baseline and 4-week post-treatment period). Secondary outcomes include change in day with elevated headache triggers and headache-related disability. If TABS-PM were found to have superior efficacy to usual care, this would indicate that TABS-PM is an efficacious behavioral intervention for reducing episodes of migraine. If TABS-PM were found to have superior efficacy to generic self-administered behavioral treatment, this would indicate that tailoring messages is an important part of maximizing the efficacy of self-administered behavioral treatments for migraine prevention.