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Conour CN, Sugiwaka H, Nelson CI, Duncan CL. Self-Control in Pediatric Migraine Management: A Topical Review. J Pediatr Psychol 2024; 49:107-110. [PMID: 37949096 DOI: 10.1093/jpepsy/jsad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/28/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE This review examines the role that two types of self-control may play in youth's self-management of migraine. Although traditionally conceptualized from an inhibitory lens, self-control has both initiatory and inhibitory functions, and the authors suggest the distinction is important in relation to youth's ability to adhere to different components of migraine treatment regimens. METHODS A topical review of the literature was conducted to identify evidence-based interventions to treat pediatric migraine and conceptualize the role self-control (both initiatory and inhibitory) may play in adherence to its regimen. Both PsycInfo and PubMed databases were used to identify relevant articles. RESULTS Existing evidence-based interventions and recommendations for pediatric migraine require inhibitory self-control (e.g., avoiding caffeine, tobacco) and initiatory self-control (e.g., taking medication). Formal intervention programs (e.g., cognitive behavioral therapy) tend to employ initiatory self-control (e.g., modifying physical reactions in response to biofeedback). CONCLUSIONS Understanding the distinct types of self-control required for adherence to different interventions allows for a better conceptualization of self-management of pediatric migraine. Individuals may struggle with adherence when they have deficits in one or both types of self-control skills. Future research should consider whether self-control is associated with differential adherence patterns in pediatric migraine management.
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Monteith TS, Stark-Inbar A, Shmuely S, Harris D, Garas S, Ironi A, Kalika P, Irwin SL. Remote electrical neuromodulation (REN) wearable device for adolescents with migraine: a real-world study of high-frequency abortive treatment suggests preventive effects. FRONTIERS IN PAIN RESEARCH 2023; 4:1247313. [PMID: 38028429 PMCID: PMC10657883 DOI: 10.3389/fpain.2023.1247313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Migraine is a chronic neurological disease manifesting as attacks of disabling head pain and associated symptoms. Remote electrical neuromodulation (REN) is a non-pharmacological, prescribed, wearable device (Nerivio®). This device has been certified by the FDA for the acute and/or preventive treatment of migraine with or without aura in patients 12 years of age or older. The device is affixed to the user's arm during 45-min treatment sessions and is operated using a smartphone app. This study (NCT05769322) aims to evaluate whether frequent use of REN for the acute treatment of migraine in adolescents resulted in a reduction in monthly migraine treatment days (MMTD), as previously demonstrated in adults through a dedicated prevention clinical trial (NCT04828707). Methods The study included real-world prospective data from adolescent patients who used REN on at least 10 days every 28-day month, following the REN migraine prevention guideline of an every-other-day pattern. Additional requirements were at least three REN treatment days in each of the two subsequent months. The number of MMTD was used as a proxy measure for the number of monthly migraine days (MMD). The change in MMTD from the first month, taken as a "baseline," to each of the following months was used to evaluate the presence and size of potential migraine preventive benefits of REN in adolescents. Results A total of 83 adolescents were eligible for analysis. The users were 15.9 ± 1.3 years of age (mean ± SD), and 89% of them were female. The results demonstrated a substantial month-to-month reduction in the mean (±SD) number of REN treatment days from 12.6 (±3.2) MMTD in the first month to 9.0 (±4.8) MMTD in the second month (p < 0.001), and a further decrease to 7.4 (±4.2) MMTD in the third month (p < 0.001). This indicates an accumulative reduction of 5.2 (±4.8) mean REN MMTD from the first month to the third month of consecutive REN treatment. The users also reported consistent 2-h acute pain responses in at least 50% of their treated attacks, with 61.9% of the users reported experiencing pain relief, 24.5% reported pain freedom, 67.4% indicated relief in functional disability, and 41.3% reported complete freedom from functional disability. Conclusion The frequent use of REN among adolescents as an acute treatment for migraine attacks resulted in a decrease in the mean number of monthly treatment days in the subsequent months, suggesting that REN may have potential preventive benefits for migraine in this subpopulation.
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Affiliation(s)
| | | | - Sharon Shmuely
- Clinical Development Department, Theranica, Netanya, Israel
| | - Dagan Harris
- Clinical Development Department, Theranica, Netanya, Israel
| | - Sandy Garas
- Clinical Development Department, Theranica, Netanya, Israel
| | - Alon Ironi
- Clinical Development Department, Theranica, Netanya, Israel
| | - Paige Kalika
- Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Samantha L. Irwin
- Department of Neurology, UCSF Benioff Children’s Hospitals, San Francisco, CA, United States
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3
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Gago-Veiga AB, Camiña Muñiz J, García-Azorín D, González-Quintanilla V, Ordás CM, Torres-Ferrus M, Santos-Lasaosa S, Viguera-Romero J, Pozo-Rosich P. Headache: What to ask, how to examine, and which scales to use. Recommendations of the Spanish Society of Neurology's Headache Study Group. Neurologia 2022; 37:564-574. [PMID: 30929913 DOI: 10.1016/j.nrl.2018.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/05/2018] [Accepted: 12/22/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Headache is the most common neurological complaint at the different levels of the healthcare system, and clinical history and physical examination are essential in the diagnosis and treatment of these patients. With the objective of unifying the care given to patients with headache, the Spanish Society of Neurology's Headache Study Group (GECSEN) has decided to establish a series of consensus recommendations to improve and guarantee adequate care in primary care, emergency services, and neurology departments. METHODS With the aim of creating a practical document, the recommendations follow the dynamics of a medical consultation: clinical history, physical examination, and scales quantifying headache impact and disability. In addition, we provide recommendations for follow-up and managing patients' expectations of the treatment. CONCLUSIONS With this tool, we aim to improve the care given to patients with headache in order to guarantee adequate, homogeneous care across Spain.
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Affiliation(s)
- A B Gago-Veiga
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, España.
| | - J Camiña Muñiz
- Servicio de Neurología. Clínica Rotger y Hospital Quirónsalud Palmaplanas, Grupo Quirónsalud, Palma de Mallorca, España
| | - D García-Azorín
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - V González-Quintanilla
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - C M Ordás
- Servicio de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
| | - M Torres-Ferrus
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Barcelona, España
| | - S Santos-Lasaosa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J Viguera-Romero
- Unidad Gestión Clínica de Neurología, Hospital Virgen Macarena, Sevilla, España
| | - P Pozo-Rosich
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Barcelona, España
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4
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Gibler RC, Knestrick KE, Reidy BL, Lax DN, Powers SW. Management of Chronic Migraine in Children and Adolescents: Where are We in 2022? Pediatric Health Med Ther 2022; 13:309-323. [PMID: 36110896 PMCID: PMC9470380 DOI: 10.2147/phmt.s334744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Migraine is a neurological disorder that affects millions of children and adolescents worldwide. Chronic migraine is a subtype of migraine in which patients experience headaches for more days than not each month, with accompanying symptoms of phonophobia, photophobia, nausea or vomiting for most of these headaches. The burden and impact of chronic migraine in the daily lives of children and adolescents is substantial, requiring a holistic, multidisciplinary, and biopsychosocial approach to conceptualization and treatment. The purpose of this review is to provide a comprehensive “2022” overview of acute and preventive treatments for the management of chronic migraine in youth. We first describe diagnostic criteria for chronic migraine and highlight the state of evidence for acute and preventive treatment in children and adolescents. We then discuss emerging treatments currently receiving rigorous clinical research effort, special considerations for the treatment of chronic migraine in children and adolescents, and avenues for improving existing treatments and expanding access to evidence-based care.
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Affiliation(s)
- Robert C Gibler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Correspondence: Robert C Gibler, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA, Email
| | - Kaelynn E Knestrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Brooke L Reidy
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Daniel N Lax
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Scott W Powers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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5
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Gago-Veiga A, Camiña Muñiz J, García-Azorín D, González-Quintanilla V, Ordás C, Torres-Ferrus M, Santos-Lasaosa S, Viguera-Romero J, Pozo-Rosich P. Headache: what to ask, how to examine, and what scales to use. Recommendations of the Spanish society of neurology’s headache study group. NEUROLOGÍA (ENGLISH EDITION) 2022; 37:564-574. [DOI: 10.1016/j.nrleng.2018.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/22/2018] [Indexed: 10/22/2022] Open
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6
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Bonfert MV, Sollmann N, Renner T, Börner C, Urban G, Schandelmaier P, Hannibal I, Huß K, Parisi C, Gerstl L, Vill K, Blaschek A, Koenig H, Klose B, Heinen F, Landgraf MN, Albers L. Burden of disease and lifestyle habits in adolescents and young adults prone
to frequent episodic migraine: A secondary comparative analysis. J Child Health Care 2022; 26:215-227. [PMID: 33955272 PMCID: PMC9194962 DOI: 10.1177/13674935211008712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to assess the burden of disease and prevalence of lifestyle factors for adolescents and young adults with frequent episodic migraine. We conducted a secondary comparative analysis of data collected during two previous studies. Inclusion criteria for this analysis were age 15-35 years, 15 to 44 migraine episodes within 12 weeks, and completeness of Migraine Disability Assessment and lifestyle questionnaire data. Datasets of 37 adults (median age [interquartile range]: 25 [6]) and 27 adolescents (median age [interquartile range]: 15 [1]) were analyzed. 81% (n = 30) of adults reported severe disability (16% [n = 3] of adolescents; p < 0.001). Headache frequency (24 vs. 17 days; p = 0.005) and prevalence of regular analgesic use (60% [n = 22] vs. 18% [n = 5]; p = 0.002) were significantly higher in adults. In adults, sleep duration on weekdays was significantly lower (8.5 vs. 10 h; p < 0.001). Any consumption of caffeine tended to be higher in adolescents and alcohol consumption tended to be higher in adults (p > 0.05). This study underlines the importance of educating adolescents and young adults with migraine about lifestyle habits that are likely to interfere with the condition.
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Affiliation(s)
- Michaela V Bonfert
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Michaela V Bonfert, Department of Pediatric
Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity,
Dr von Hauner Children’s Hospital, LMU Hospital, Lindwurmstraße 4, Munich, Bavaria 80337,
Germany.
| | - Nico Sollmann
- Department of Diagnostic and Interventional
Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Germany,TUM-Neuroimaging Center, Klinikum Rechts
der Isar, Technical University of Munich, Germany,Department of Diagnostic and Interventional
Radiology, University Hospital Ulm, Germany
| | - Tabea Renner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Corinna Börner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Giada Urban
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Paul Schandelmaier
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Iris Hannibal
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Kristina Huß
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Carmen Parisi
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Gerstl
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Katharina Vill
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Astrid Blaschek
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Helene Koenig
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Birgit Klose
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Albers
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Department of Neurosurgery, Klinikum Rechts
der Isar, Technical University of Munich, Germany
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7
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Mason M, Cho Y, Rayo J, Gong Y, Harris M, Jiang Y. Technologies for Medication Adherence Monitoring and Technology Assessment Criteria: Narrative Review. JMIR Mhealth Uhealth 2022; 10:e35157. [PMID: 35266873 PMCID: PMC8949687 DOI: 10.2196/35157] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/23/2022] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Accurate measurement and monitoring of patient medication adherence is a global challenge because of the absence of gold standard methods for adherence measurement. Recent attention has been directed toward the adoption of technologies for medication adherence monitoring, as they provide the opportunity for continuous tracking of individual medication adherence behavior. However, current medication adherence monitoring technologies vary according to their technical features and data capture methods, leading to differences in their respective advantages and limitations. Overall, appropriate criteria to guide the assessment of medication adherence monitoring technologies for optimal adoption and use are lacking. OBJECTIVE This study aims to provide a narrative review of current medication adherence monitoring technologies and propose a set of technology assessment criteria to support technology development and adoption. METHODS A literature search was conducted on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (2010-present) using the combination of keywords medication adherence, measurement technology, and monitoring technology. The selection focused on studies related to medication adherence monitoring technology and its development and use. The technological features, data capture methods, and potential advantages and limitations of the identified technology applications were extracted. Methods for using data for adherence monitoring were also identified. Common recurring elements were synthesized as potential technology assessment criteria. RESULTS Of the 3865 articles retrieved, 98 (2.54%) were included in the final review, which reported a variety of technology applications for monitoring medication adherence, including electronic pill bottles or boxes, ingestible sensors, electronic medication management systems, blister pack technology, patient self-report technology, video-based technology, and motion sensor technology. Technical features varied by technology type, with common expectations for using these technologies to accurately monitor medication adherence and increase adoption in patients' daily lives owing to their unobtrusiveness and convenience of use. Most technologies were able to provide real-time monitoring of medication-taking behaviors but relied on proxy measures of medication adherence. Successful implementation of these technologies in clinical settings has rarely been reported. In all, 28 technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability. CONCLUSIONS This narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology reported in the literature and the proposed criteria for assessing medication adherence monitoring technologies. This collection of assessment criteria can be a useful tool to guide the development and selection of relevant technologies, facilitating the optimal adoption and effective use of technology to improve medication adherence outcomes. Future studies are needed to further validate the medication adherence monitoring technology assessment criteria and construct an appropriate technology assessment framework.
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Affiliation(s)
- Madilyn Mason
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Youmin Cho
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Jessica Rayo
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Yang Gong
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Marcelline Harris
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
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8
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Parsons RD, McParland J, Jordan A. Commentary: Multimodal Assessment of Medication Adherence Among Youth With Migraine: An Ancillary Study of the CHAMP Trial. J Pediatr Psychol 2022; 47:388-390. [PMID: 35182147 DOI: 10.1093/jpepsy/jsac009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 01/31/2022] [Accepted: 01/31/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ryan D Parsons
- Department of Psychology, University of Bath, UK.,Centre for Pain Research, University of Bath, UK
| | | | - Abbie Jordan
- Department of Psychology, University of Bath, UK.,Centre for Pain Research, University of Bath, UK
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9
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Reidy BL, Powers SW, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW, Korbee LL, Porter LL, Peugh J, Kabbouche MA, Kacperski J, Hershey AD. Multimodal Assessment of Medication Adherence Among Youth With Migraine: An Ancillary Study of the CHAMP Trial. J Pediatr Psychol 2021; 47:376-387. [PMID: 34865085 DOI: 10.1093/jpepsy/jsab123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Examine preventive medication adherence among youth with migraine. METHODS Adherence (self-report, pill count, and blood serum drug levels) was assessed as an ancillary study that utilized data from 328 CHAMP Study participants (ages 8-17). CHAMP was a multisite trial of preventive medications. Participants completed a prospective headache diary during a six-month active treatment period during which youth took amitriptyline, topiramate, or placebo pill twice daily. Self-reported medication adherence was collected via daily diary. At monthly study visits, pill count measures were captured. At trial month 3 (trial midpoint) and 6 (end of active trial), blood serum drug levels were obtained. Self-report and pill count adherence percentages were calculated for the active trial period, at each monthly study visit, and in the days prior to participants' mid-trial blood draw. Percentages of nonzero drug levels were calculated to assess blood serum drug level data. Adherence measures were compared and assessed in context of several sociodemographic factors. Multiple regression analyses investigated medication adherence as a predictor of headache outcomes. RESULTS Self-report and pill count adherence rates were high (over 90%) and sustained over the course of the trial period. Serum drug level adherence rates were somewhat lower and decreased significantly (from 84% to 76%) across the trial period [t (198) = 3.23, p = .001]. Adherence measures did not predict headache days at trial end; trial midpoint serum drug levels predicted headache-related disability. CONCLUSIONS Youth with migraine can demonstrate and sustain relatively high levels of medication adherence over the course of a clinical trial.
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Affiliation(s)
- Brooke L Reidy
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Scott W Powers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Christopher S Coffey
- Department of Biostatistics, Clinical Trials Statistical and Data Management Center, University of Iowa, USA
| | - Leigh A Chamberlin
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA
| | - Dixie J Ecklund
- Department of Biostatistics, Clinical Trials Statistical and Data Management Center, University of Iowa, USA
| | - Elizabeth A Klingner
- Department of Biostatistics, Clinical Trials Statistical and Data Management Center, University of Iowa, USA
| | - Jon W Yankey
- Department of Biostatistics, Clinical Trials Statistical and Data Management Center, University of Iowa, USA
| | | | - Linda L Porter
- The National Institute of Neurological Disorders and Stroke, USA
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA
| | - Marielle A Kabbouche
- Department of Pediatrics, University of Cincinnati College of Medicine, USA.,Division of Neurology, Cincinnati Children's Hospital Medical Center, USA
| | - Joanne Kacperski
- Department of Pediatrics, University of Cincinnati College of Medicine, USA.,Division of Neurology, Cincinnati Children's Hospital Medical Center, USA
| | - Andrew D Hershey
- Department of Pediatrics, University of Cincinnati College of Medicine, USA.,Division of Neurology, Cincinnati Children's Hospital Medical Center, USA
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Abstract
PURPOSE OF REVIEW This article reviews the approach to a child or adolescent with headache, the criteria for common diagnoses, and the evidence base for treatments. RECENT FINDINGS The guidelines for acute and preventive treatment of migraine were updated in 2019. These guidelines summarize the available evidence and outline the questions that should be addressed in future research. The US Food and Drug Administration (FDA) approval of several new classes of drugs and devices to treat adult migraine in the past few years has resulted in ongoing or planned pediatric trials. SUMMARY Headache is a common symptom in children, and it is important to take a detailed history and perform a thorough physical examination to make the diagnosis. Nearly 1 in 10 children experience recurrent headaches due to migraine, which cause significant impairment in school performance and quality of life. The acute and preventive treatments that are currently available will help at least two-thirds of children with migraine, and several trials of new therapies offer hope for the future.
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11
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Rosenthal S, Yonker M. Telemedicine in Pediatric Headache: A Review and Practical Implementation. Curr Neurol Neurosci Rep 2021; 21:27. [PMID: 33844073 PMCID: PMC8038919 DOI: 10.1007/s11910-021-01112-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/15/2022]
Abstract
Purpose of Review The purpose of this review was to summarize the current literature about telemedicine in pediatric headache and to provide practical guidance for its implementation. Recent Findings There are few studies dedicated to telemedicine in pediatric headache, and existing studies are small. Patients and families report high levels of satisfaction with telemedicine, and most are willing to continue telemedicine visits in the future. Telemedicine demonstrated similar reductions in headache frequency, severity, and duration as patients treated in-person. Remotely delivered psychologic interventions have some utility in reducing headache severity acutely. Families feel telemedicine reduces geographic and financial barriers to care. Summary Telemedicine in pediatric headache is a growing field. While there is limited research available, it appears safe, efficacious, and feasible. Headache-related outcomes, including frequency, severity, and duration, were similar amongst telemedicine and in-person visits. Future studies should include larger sample sizes and detailed analysis of adverse outcomes.
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Affiliation(s)
- Scott Rosenthal
- Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave., Aurora, CO, 80045, USA.
| | - Marcy Yonker
- Pediatric Headache Program Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave., Aurora, CO, 80045, USA
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12
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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13
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Efficacy and Feasibility of Behavioral Treatments for Migraine, Headache, and Pain in the Acute Care Setting. Curr Pain Headache Rep 2020; 24:66. [PMID: 32979092 DOI: 10.1007/s11916-020-00899-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This narrative review examines the use of behavioral interventions for acute treatment of headache and pain in the emergency department (ED)/urgent care (UC) and inpatient settings. RECENT FINDINGS Behavioral interventions demonstrate reductions of pain and associated disability in headache, migraine, and other conditions in the outpatient setting. Behavioral treatments may be a useful addition for patients presenting with acute pain to hospitals and emergency departments. We review challenges and limitations and offer suggestions for implementation of behavioral interventions in the acute setting. Some evidence exists for relaxation-based treatments, mindfulness-based treatments, hypnosis/self-hypnosis, and immersive virtual reality for acute pain, migraine, and headache. There are few high-quality studies on behavioral treatments in the inpatient and emergency department settings. Further research is warranted to determine the efficacy and cost-effectiveness of these interventions. Given the general safety and cost-effectiveness of behavioral interventions, healthcare professionals may want to include these therapies in treatment plans.
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14
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Zhao YJ, Ho KH, Wong PS. Early clinical experience with a monoclonal antibody against the calcitonin gene-related peptide receptor in adolescents with migraine: A case series. PROCEEDINGS OF SINGAPORE HEALTHCARE 2020. [DOI: 10.1177/2010105820935465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Management of migraine in adolescents poses a great challenge, as many of the approved pharmacological migraine preventive agents have age restrictions. Following favorable safety and efficacy reports of the new class agent calcitonin gene-related peptide (CGRP) monoclonal antibody for use in migraine prevention, there is growing interest in its application in pediatric migraine. We present here a case series detailing our experience of using erenumab, a CGRP monoclonal antibody, in six adolescent patients. Two patients had a reduction of at least 50% in the mean number of monthly migraine days, one patient reported subjective improvement, while three patients did not respond to the first dose of erenumab and discontinued treatment. One patient reported constipation associated with erenumab use. We speculate that CGRP monoclonal antibody could potentially be a viable option in adolescent patients with migraine. Further evidences that support efficacy and safety of erenumab in this group is needed.
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Affiliation(s)
- Yi Jing Zhao
- Department of Neurology, National Neuroscience Institute – Singapore General Hospital Campus, Singapore
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15
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van de Graaf DL, Schoonman GG, Habibović M, Pauws SC. Towards eHealth to support the health journey of headache patients: a scoping review. J Neurol 2020; 268:3646-3665. [PMID: 32529582 PMCID: PMC8463346 DOI: 10.1007/s00415-020-09981-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study is to (1) review the digital health tools that have been used in headache studies, and (2) discuss the effectivity and reliability of these tools. Background Many headache patients travel a long and troublesome journey from first symptoms until a meaningful care plan. eHealth, mHealth, and digital therapeutic modalities have been advocated as the way forward to improve patient care. Method Online databases PubMed, Cinahl, and PsycINFO were searched using a predefined search query. A data extraction form was used to gather relevant data elements from the selected papers. Results A total of 39 studies were selected. The studies included 94,127 participants. The majority of studies focused on diaries (N = 27 out of 39). Digital (cognitive) behavioral therapy were also quite common (N = 7 out of 39). Other digital health tool categories were tele-consultations, telemonitoring and patient portals. Conclusion Many digital health tools for headache patients regarding diaries and behavioral/therapeutical treatment are described in scientific research with limited information on effectivity and reliability. Scientific knowledge with regard to other categories such as tele-consultations, patient portals, telemonitoring including medication adherence, online information resources, wearable, symptom checkers, digital peer support is still scarce or missing.
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Affiliation(s)
| | - Guus G Schoonman
- Department of Neurology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Cardiology, Elizabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Steffen C Pauws
- TiCC-Tilburg University, Tilburg, The Netherlands.,Philips Research, Healthcare, Eindhoven, The Netherlands
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16
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Headache Hygiene in Pediatrics: Brushing Up on the Basics. Pediatr Neurol 2020; 103:3-7. [PMID: 31843350 DOI: 10.1016/j.pediatrneurol.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/02/2019] [Accepted: 10/10/2019] [Indexed: 01/18/2023]
Abstract
Headache hygiene refers to self-management behaviors and practices aimed at reducing headache-related disability and improving self-efficacy. Although self-management interventions have an established place in the management of a wide range of chronic conditions, there is still not a standardized approach to this in pediatric headache. In this article, we focus on headache hygiene approaches including education, lifestyle interventions, and psychologic interventions. We also present our center's resource compilation, made available to patients by quick response code technology, as an example of a structured approach to headache hygiene. Further work should explore a standardized approach to headache hygiene and strategies to support adherence, including the use of technology as an innovative health care delivery pathway.
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17
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Tomines A. Pediatric Telehealth: Approaches by Specialty and Implications for General Pediatric Care. Adv Pediatr 2019; 66:55-85. [PMID: 31230700 DOI: 10.1016/j.yapd.2019.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Alan Tomines
- Department of Pediatrics, UCLA Geffen School of Medicine, Los Angeles, CA, USA; Enterprise Information Services, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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18
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Papetti L, Ursitti F, Moavero R, Ferilli MAN, Sforza G, Tarantino S, Vigevano F, Valeriani M. Prophylactic Treatment of Pediatric Migraine: Is There Anything New in the Last Decade? Front Neurol 2019; 10:771. [PMID: 31379721 PMCID: PMC6646427 DOI: 10.3389/fneur.2019.00771] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/02/2019] [Indexed: 12/25/2022] Open
Abstract
Migraine is a frequent and very disabling disease, especially at pediatric age. Despite this, there are few controlled data on the prophylactic treatment of primary headaches in this category of age. Given that the recently introduced calcitonin gene-related peptide (CGRP) inhibitors (CGRP-r) are still limited to adulthood, there is no drug with exclusive indication for migraine treatment in pediatric age. This raises several limitations in terms of adherence and effectiveness of the therapy. Moreover, the scenario is complicated by placebo response, which is larger in children and adolescents than in adults and often leads to an improvement in the attack frequency even in absence of any active pharmacological treatment. Our aim was to investigate the real evidence concerning the prophylactic therapy of pediatric migraine by reviewing the clinical studies published between 2010 and 2019.
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Affiliation(s)
- Laura Papetti
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Fabiana Ursitti
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Romina Moavero
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy.,Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | | | - Giorgia Sforza
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Samuela Tarantino
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Federico Vigevano
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Massimiliano Valeriani
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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19
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Charleston L, Royce J, Monteith TS, Broner SW, O'Brien HL, Manrriquez SL, Robbins MS. Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: A Narrative Review, Part 2. Headache 2019; 58:633-647. [PMID: 29878343 DOI: 10.1111/head.13321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review the challenges and potential solutions in treatment options for quality migraine care in adult patients who are under or uninsured. BACKGROUND The Affordable Care Act has improved access to health care for many; however, those who are underserved continue to face treatment disparities and have inadequate access to appropriate migraine management. METHODS This manuscript is the second of a 2-part narrative review which was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society. Literature was reviewed for key concepts underpinning conceptual boundaries and a broad overview of the subject matter. Published guidelines, state-specific Medicaid websites, headache quality measurement sets, literature review, and expert opinion were used to tailor suggested treatment options and therapeutic strategies. In this second part of our narrative review, we explored migraine care strategies and considerations for underserved and vulnerable adult populations with migraine. RESULTS Although common, migraine remains untreated, particularly among those of low socioeconomic status. Low socioeconomic status may play an important role in the disease progression, prescription of hazardous medications such as opioids, outcomes, and quality of life of patients with migraine and other headache disorders. There are some evidence-based and guideline supported treatment options available at low cost that include prescription medications and supplements, though approved devices are costly. Resources available online and simple nonpharmacological strategies may be particularly useful in the underserved migraine population. CONCLUSIONS We identified and discussed migraine treatment barriers that affect underserved populations in the US and summarized practical, cost-effective strategies to surmount them. However, more research is needed to identify the best cost-effective measures for migraine management in underserved and vulnerable patients who are uninsured or underinsured.
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Affiliation(s)
- Larry Charleston
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey Royce
- Neuro and Headache Center, SwedishAmerican Hospital, Rockford, IL, USA
| | - Teshamae S Monteith
- Department of Neurology-Headache Division, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Susan W Broner
- Weill Cornell Medicine Headache Program, Department of Neurology, Weill Cornell Medical College, New York, NY, USA
| | - Hope L O'Brien
- Division of Neurology, Cincinnati Children's Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Salvador L Manrriquez
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Matthew S Robbins
- Department of Neurology, Albert Einstein College of Medicine, Montefiore Headache Center, Bronx, NY, USA
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20
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Abstract
Pediatric primary headache disorders are best treated using a comprehensive and integrative approach, due to the complex interactions between psychosocial and biological processes. Although more quality research is needed for treatment approaches to pediatric headaches, current practice management includes both pharmaceutical and nonpharmaceutical management. This article describes the integrative treatments used in a large regional pediatric headache program. Lifestyle approaches, nutraceuticals and dietary supplements, acupuncture, transcutaneous neurostimulation, relaxation, clinical hypnosis, biofeedback, and psychological services are discussed in detail for clinicians who may consider applying to their practice. [Pediatr Ann. 2019;48(6):e231-e235.].
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21
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Connelly M, Sekhon S. Current perspectives on the development and treatment of chronic daily headache in children and adolescents. Pain Manag 2019; 9:175-189. [PMID: 30681030 DOI: 10.2217/pmt-2018-0057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Headache disorders subsumed under the term chronic daily headache (CDH), including chronic migraine, chronic tension-type headache and new daily persistent headache, affect up to 4% of the pediatric population and can be highly disabling and challenging to effectively treat. Although historically the knowledge base about this group of headache disorders in children primarily was derived from clinical observation and extrapolation from adult studies, over the past several years there have been important research findings relevant to the development and management of pediatric CDH that can help inform clinical practice. The intent of this paper is to provide a focused review on recent empirical work done on pediatric CDH and suggest avenues for future work.
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Affiliation(s)
- Mark Connelly
- Department of Pediatrics, Division of Developmental and Behavioral Sciences, Children's Mercy Hospitals & Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Subhjit Sekhon
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64110, USA
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22
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Higgins KS, Tutelman PR, Chambers CT, Witteman HO, Barwick M, Corkum P, Grant D, Stinson JN, Lalloo C, Robins S, Orji R, Jordan I. Availability of researcher-led eHealth tools for pain assessment and management: barriers, facilitators, costs, and design. Pain Rep 2018; 3:e686. [PMID: 30324177 PMCID: PMC6172815 DOI: 10.1097/pr9.0000000000000686] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Numerous eHealth tools for pain assessment and management have been developed and evaluated with promising results regarding psychometric properties, efficacy, and effectiveness. Although considerable resources are spent on developing and evaluating these tools with the aim of increasing access to care, current evidence suggests they are not made available to end users, reducing their impact and creating potential research waste. METHODS This study consisted of 2 components: (1) a systematic review of eHealth tools for pediatric pain assessment and/or management published in the past 10 years, and (2) an online survey, completed by the authors of identified tools, of tool availability, perceived barriers or facilitators to availability, grant funding used, and a validated measure of user-centeredness of the design process (UCD-11). RESULTS Ninety articles (0.86% of citations screened) describing 53 tools met inclusion criteria. Twenty-six survey responses were completed (49.06%), 13 of which (50.00%) described available tools. Commonly endorsed facilitators of tool availability included researchers' beliefs in tool benefits to the target population and research community; barriers included lack of infrastructure and time. The average cost of each unavailable tool was $314,425.31 USD ($3,144,253.06 USD total, n = 10). Authors of available tools were more likely to have followed user-centered design principles and reported higher total funding. CONCLUSION Systemic changes to academic and funding structures could better support eHealth tool availability and may reduce potential for research waste. User-centered design and implementation science methods could improve the availability of eHealth tools and should be further explored in future studies.
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Affiliation(s)
- Kristen S. Higgins
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
| | - Perri R. Tutelman
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
| | - Christine T. Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Holly O. Witteman
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Québec City, Canada
- CHU de Québec, Québec City, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Melanie Barwick
- Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Penny Corkum
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Colchester East Hands ADHD Clinic, Colchester East Hants Health Authority, Truro, Canada
| | - Doris Grant
- Industry Liaison and Innovation, Dalhousie University, Halifax, Canada
| | - Jennifer N. Stinson
- Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children, Toronto, Canada
- Chronic Pain Program, The Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Chitra Lalloo
- Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Sue Robins
- Patient Advocate and Partner, Bird Communications, Vancouver, Canada
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, Canada
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Stubberud A, Linde M. Digital Technology and Mobile Health in Behavioral Migraine Therapy: a Narrative Review. Curr Pain Headache Rep 2018; 22:66. [PMID: 30066141 DOI: 10.1007/s11916-018-0718-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW This article reviews the recent research and development of electronic health (eHealth) and, in particular, mobile health (mHealth) strategies to deliver behavioral treatment for migraine. Prospects for future development and research of mobile health in migraine are suggested. RECENT FINDINGS Advances in digital technology and mobile technology have led to an era where electronic and mobile approaches are applied to several aspects of healthcare. Electronic behavioral interventions for migraine seem to be acceptable and feasible, but efficacy measures are uncertain. Clinical trials on mHealth-based classical behavioral therapies, such as relaxation, biofeedback, and cognitive behavioral therapy are missing in the literature. Within mHealth, headache diaries are the most researched and scientifically developed. Still, there is a gap between commercially available apps and scientifically validated and developed apps. Digital technology and mobile health has not yet lived out its potential in behavioral migraine therapy. Application of proper usability and functionality designs towards the right market, together with appraisal of medical and technological recommendations, may facilitate rapid development of eHealth and mHealth, while also establishing scientific evidence.
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Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, NO-7489, Trondheim, Norway.
| | - Mattias Linde
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, NO-7489, Trondheim, Norway.,Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, NO-7006, Trondheim, Norway
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24
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Orr SL, Kabbouche MA, O’Brien HL, Kacperski J, Powers SW, Hershey AD. Paediatric migraine: evidence-based management and future directions. Nat Rev Neurol 2018; 14:515-527. [DOI: 10.1038/s41582-018-0042-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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25
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Agosti R. Migraine Burden of Disease: From the Patient's Experience to a Socio-Economic View. Headache 2018; 58 Suppl 1:17-32. [DOI: 10.1111/head.13301] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/28/2018] [Accepted: 03/28/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Reto Agosti
- Headache Center Zurich Hirslanden; Zurich Switzerland
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26
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Dodick DW. A Phase-by-Phase Review of Migraine Pathophysiology. Headache 2018; 58 Suppl 1:4-16. [DOI: 10.1111/head.13300] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 02/06/2023]
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27
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Ramsey RR, Holbein CE, Powers SW, Hershey AD, Kabbouche MA, O'Brien HL, Kacperski J, Shepard J, Hommel KA. A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine. Cephalalgia 2018; 38:2035-2044. [PMID: 29635937 DOI: 10.1177/0333102418756864] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Effective management of migraine requires adherence to treatment recommendations; however, adolescents with migraine take their daily medications only 75% of the time. Low-cost adherence-focused interventions using technology may improve adherence, but have not been investigated. METHODS Thirty-five adolescents and young adults (13-21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone adherence-promotion application ("app") and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. RESULTS Relative to baseline, adherence significantly improved during the first month of the intervention. Specifically, improvements existed for older participants with lower baseline adherence. Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates. Participants rated the intervention as acceptable and easy to use. CONCLUSIONS "Apps" have the potential to improve medication adherence and are a promising intervention for adolescents and young adults with low adherence. Involving parents in the intervention is also helpful. Providers should assess barriers to adherence and use of technology-based interventions, encourage parents to incorporate behavioral incentives, and provide referrals for more intensive interventions to improve long-term outcomes. Further, tracking adherence in an app may result in an underestimation of adherence. Future full-scale studies should be conducted to examine adherence promotion app interventions.
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Affiliation(s)
- Rachelle R Ramsey
- 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Christina E Holbein
- 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Scott W Powers
- 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,3 Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Andrew D Hershey
- 2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,3 Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,4 Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Marielle A Kabbouche
- 2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,3 Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,4 Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Hope L O'Brien
- 2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,3 Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,4 Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joanne Kacperski
- 2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,3 Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,4 Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Kevin A Hommel
- 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Kroon Van Diest AM, Ramsey R, Kashikar-Zuck S, Slater S, Hommel K, Kroner JW, LeCates S, Kabbouche MA, O’Brien HL, Kacperski J, Allen JR, Peugh J, Hershey AD, Powers SW. Treatment Adherence in Child and Adolescent Chronic Migraine Patients: Results From the Cognitive-Behavioral Therapy and Amitriptyline Trial. Clin J Pain 2017; 33:892-898. [PMID: 28118256 PMCID: PMC5522369 DOI: 10.1097/ajp.0000000000000481] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To examine treatment adherence among children and adolescents with chronic migraine who volunteered to be in a clinical trial using 3 measures: treatment session attendance, therapy homework completion, and preventive medication use by daily diary. MATERIALS AND METHODS Analyses are secondary from a trial of 135 youth aged 10 to 17 years diagnosed with chronic migraine and with a Pediatric Migraine Disability Score over 20. Participants were randomly assigned to cognitive-behavioral therapy plus amitriptyline (CBT+A, N=64) or headache education plus amitriptyline (HE+A, N=71). Therapists recorded session attendance. Completion of homework/practice between sessions was reported to therapists by patients. Patients reported preventive medication adherence using a daily headache diary. RESULTS Mean session attendance adherence out of 10 treatment sessions was 95% for CBT+A and 99% for HE+A. CBT+A participants reported completing a mean of 90% of home practice of CBT skills between the 10 sessions. Participants reported taking amitriptyline daily at a mean level of 90% when missing diaries were excluded and 79% when missing diaries were considered as missed doses of medication. DISCUSSION Our findings demonstrate that youth with chronic migraine who agree to be a part of a clinical trial do quite well at attending therapy sessions, and report that they are adherent to completing home/practice between sessions and taking medication. These results lend further support to consideration of CBT+A as a first-line treatment for youth with chronic migraine and suggest that measurement of adherence when this treatment is provided in practice will be important.
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Affiliation(s)
- Ashley M. Kroon Van Diest
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Rachelle Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Susmita Kashikar-Zuck
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Shalonda Slater
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Kevin Hommel
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - John W. Kroner
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Susan LeCates
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Marielle A. Kabbouche
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Hope L. O’Brien
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Joanne Kacperski
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Janelle R. Allen
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Andrew D. Hershey
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Scott W. Powers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
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Powers SW, Hershey AD, Coffey CS. The Childhood and Adolescent Migraine Prevention (CHAMP) Study: "What Do We Do Now?". Headache 2017; 57:180-183. [PMID: 28128463 DOI: 10.1111/head.13025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 11/27/2022]
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