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.
RCT Entities:
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+Aparticipants 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.
Authors: J Olesen; M-G Bousser; H-C Diener; D Dodick; M First; P J Goadsby; H Göbel; M J A Lainez; J W Lance; R B Lipton; G Nappi; F Sakai; J Schoenen; S D Silberstein; T J Steiner Journal: Cephalalgia Date: 2006-06 Impact factor: 6.292
Authors: Susmita Kashikar-Zuck; Tracy V Ting; Lesley M Arnold; Judy Bean; Scott W Powers; T Brent Graham; Murray H Passo; Kenneth N Schikler; Philip J Hashkes; Steven Spalding; Anne M Lynch-Jordan; Gerard Banez; Margaret M Richards; Daniel J Lovell Journal: Arthritis Rheum Date: 2012-01
Authors: Donald B Penzien; Frank Andrasik; Brian M Freidenberg; Timothy T Houle; Alvin E Lake; Gay L Lipchik; Kenneth A Holroyd; Richard B Lipton; Douglas C McCrory; Justin M Nash; Robert A Nicholson; Scott W Powers; Jeanetta C Rains; David A Wittrock Journal: Headache Date: 2005-05 Impact factor: 5.887
Authors: John W Kroner; Andrew D Hershey; Susmita M Kashikar-Zuck; Susan L LeCates; Janelle R Allen; Shalonda K Slater; Marium Zafar; Marielle A Kabbouche; Hope L O'Brien; Chad E Shenk; Joseph R Rausch; Ashley M Kroon Van Diest; Scott W Powers Journal: Headache Date: 2016-03-18 Impact factor: 5.887
Authors: Mia T Minen; Kaitlyn Morio; Kathryn Berlin Schaubhut; Scott W Powers; Richard B Lipton; Elizabeth Seng Journal: Cephalalgia Date: 2019-12-23 Impact factor: 6.292