Comparison of a pediatric practice-based therapy and an interdisciplinary ambulatory treatment in social pediatric centers for migraine in children: a nation-wide randomized-controlled trial in Germany: "moma - modules on migraine activity"

Background

Migraine is common in childhood, peaks in adolescents and persists into adulthood in at least 40% of patients. There is need for early interventions to improve the burden of disease and, if possible, reduce chronification. The aim of the project is to compare two types of ambulatory treatment strategies regarding their effect on headache days and quality of life in 6 to 11 year old children with migraine: 1) the routine care in pediatricians’ practices (intervention group A) and 2) a structured interdisciplinary multimodal intervention administered at social pediatric centers (intervention group B).

Methods

The study is a nation-wide cluster-randomized study. Based on the postal codes the regions are randomly assigned to the two intervention-strategies. Children with migraine are recruited in the pediatric practices, as common outpatient-care in the German health-care system. Parents rate headache frequency, intensity and acute medication intake at a daily basis via a digital smartphone application specifically designed for the study. Migraine-related disability and quality of life are assessed every 3 months. Study duration is 9 months for every participant: 3 months of baseline at the pediatric practice (both groups); 3 months of intervention at the pediatric practice (intervention group A) or at the social pediatric center (intervention group B), respectively; 3 months of follow-up at the pediatric practice (both groups).

Discussion

Results of the planned comparison of routine care in pediatric practices and interdisciplinary social pediatric centers will be relevant for treatment of children with migraine, both for the individual and for the health care system.

Trial registration

The study was approved by the ethics committee at the Ludwig-Maximilians-University Munich (number 18–804) and was retrospectively registered on 27 April 2021 in the WHO approved German Clinical Trials Register (number DRKS00016698).

Prevention and health promotion from theory to practice: The interprofessional MeMPE Summer University for students of Medicine, Master of Public Health and Epidemiology

Objective: During the 2015 summer semester of Munich's Ludwig Maximilian University (LMU) medical school, the pilot project "MeMPE Summer University - An Interprofessional Seminar on Prevention and Health Promotion" was implemented as a compulsory elective subject. In 90 teaching units of 45 minutes each, 20 students from the degree programs of Medicine, Master of Public Health and Master of Science Epidemiology (MeMPE) completed modules in theoretical introduction, scientific project work as well as practical assignments and conference attendance. Methods: The project was evaluated by students using pre- and post-project questionnaires (26 and 57 items, evaluated on a Five-level Likert scale of 1="fully agree" to 5="fully disagree"). The evaluation interviews of the instruction participants were recorded, transcribed and analyzed according to Mayring's qualitative content analysis. Results: Questionnaire response rate was 100 %. In pre/post comparison, the students reported an improvement in factual knowledge (pre median=3.0; post median=2.0; p<0.0001), in scientific work (pre median=3.0; post median=1.0; p<0.0001) and in interprofessional work (pre median=2.0; post median=1.0; p=0.024). In 18 interviews, the instructors largely expressed their motivation to participate in the project again. Conclusion: The MeMPE Summer University can serve as an example of best practice for interprofessional communication of prevention and health-promotion topics in theory and practice. The evaluation results show that the project enjoyed a high level of acceptance among students and instructors, and that it should be conducted in a revised version again in 2016.