Clinical Decision Support for Patient Migraine Management (CDST)

Albert Einstein College of Medicine

Status: Completed

Conditions: Migraine

Treatments: Behavioral: Clinical Decision Support Tool; Behavioral: Headache Education

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03706794

2015-5743

1K23NS096107-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Little is known about who adheres to migraine management strategies, and circumstances that enhance adherence. This knowledge is required to develop patient-level interventions to improve adherence to migraine management strategies. The proposed project will pilot the first patient level intervention designed to improve adherence to preventive and acute migraine management strategies. The study will identify people most at risk for non-adherence to migraine management strategies. Participants will be randomly assigned to receive a tailored clinical decision support tool or education intervention.

Full description

Participants with a diagnosis with migraine who currently meet criteria for episodic migraine (migraine with headaches that occur on fewer than 15 days per month) will be recruited from local providers. After an initial screening, eligible participants will complete 30 days of monitoring 3 times daily on an electronic headache diary (a smartphone app) to confirm study eligibility. Participants whose eligibility is confirmed will complete an additional 2 months (60 days) of monitoring headache activity and adherence to acute and preventive (medication and behavioral) strategies recommended for people with migraine. Participants who show suboptimal adherence during the first 3 months of monitoring (<50% of eligible days) will be eligible to continue to the intervention component of the study. Participants who choose to continue in the study will be randomized to receive a tailored clinical decision support tool or education intervention, both delivered through the smartphone app. Participants will continue to self-monitor, with the intervention components active, for 3 months.

Enrollment: 18 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Have an International Classification of Headache Disorders - 3 beta diagnosis of migraine
• Self-report and diary-confirmed 6 to 14 headache days per month
• Are currently prescribed a triptan for acute migraine management
• Are stable on current preventive and acute treatment regimen for migraine
• Are between the ages of 18 and 65
• Reads and understands English
• Has capacity to consent
• Completes 80% of diary recordings in the first 30 days of monitoring

Exclusion criteria

• Probable or confirmed medication overuse headache
• A plan to change, or changing preventive or acute migraine medication during study participation
• Are pregnant or are planning to become pregnant during study involvement (as triptans are Category C medications)
• Psychiatric illness or cognitive difficulties that would interfere with participation in the study
• Participated in the pilot development of the intervention evaluated by this research protocol.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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18 participants in 2 patient groups

Clinical Decision Support Tool

Experimental group

Description:

Tailored education provided via a smartphone application

Treatment:

Behavioral: Clinical Decision Support Tool

Headache Education

Active Comparator group

Description:

Non-tailored education provided via a smartphone application.

Treatment:

Behavioral: Headache Education