Mia T Minen1, Gabriella Sahyoun2, Ariana Gopal3, Valeriya Levitan1, Elizabeth Pirraglia4, Naomi M Simon5, Audrey Halpern1. 1. Department of Neurology, New York University Langone Health, New York, NY, USA. 2. Department of Neuroscience, Barnard College, Columbia University, New York, NY, USA. 3. Department of Biology, The City College of New York, City University of New York, New York, NY, USA. 4. Department of Population, Biostatistics Division, New York University Langone Health, New York, NY, USA. 5. Department of Psychiatry, New York University Langone Health, New York, NY, USA.
Abstract
BACKGROUND:Relaxation, biofeedback, and cognitive behavioral therapy are evidence-based behavioral therapies for migraine. Despite such efficacy, research shows that only about half of patients initiate behavioral therapy recommended by their headache specialists. OBJECTIVE:Motivational interviewing (MI) is a widely used method to help patients explore and overcome ambivalence to enact positive life changes. We tested the hypothesis that telephone-based MI would improve initiation, scheduling, and attending behavioral therapy for migraine. METHODS: Single-blind randomized controlled trial comparing telephone-based MI to treatment as usual (TAU). Participants were recruited during their appointments with headache specialists at two sites of a New York City medical center. INCLUSION CRITERIA: ages from 16 to 80, migraine diagnosis by United Council of Neurologic Subspecialty fellowship trained and/or certified headache specialist, and referral for behavioral therapy for prevention in the appointment of recruitment. EXCLUSION CRITERIA: having done behavioral therapy for migraine in the past year. Participants in the MI group received up to 5 MI calls. TAU participants were called after 3 months for general follow-up data. The prespecified primary outcome was scheduling a behavioral therapy appointment, and secondary outcomes were initiating and attending a behavioral therapy appointment. RESULTS:76 patients were enrolled and randomized (MI = 36, TAU = 40). At baseline, the mean number of headache days was 12.0 ± 9.0. Self-reported anxiety was present for 36/52 (69.2%) and depression for 30/52 (57.7%). Follow-up assessments were completed for 77.6% (59/76, MI = 32, TAU = 27). The mean number of MI calls per participant was 2.69 ± 1.56 [0 to 5]. There was a greater likelihood of those in the MI group to initiating an appointment (22/32, 68.8% vs 11/27, 40.7%, P = .0309). There were no differences in appointment scheduling or attendance. Reasons stated for not initiating behavioral therapy were lack of time, lack of insurance/funding, prioritizing other treatments, and travel plans. CONCLUSIONS:Brief telephone-based MI may improve rates of initiation of behavioral therapy for migraine, but other barriers appear to lessen the impact on scheduling and attending behavioral therapy appointments.
RCT Entities:
BACKGROUND: Relaxation, biofeedback, and cognitive behavioral therapy are evidence-based behavioral therapies for migraine. Despite such efficacy, research shows that only about half of patients initiate behavioral therapy recommended by their headache specialists. OBJECTIVE: Motivational interviewing (MI) is a widely used method to help patients explore and overcome ambivalence to enact positive life changes. We tested the hypothesis that telephone-based MI would improve initiation, scheduling, and attending behavioral therapy for migraine. METHODS: Single-blind randomized controlled trial comparing telephone-based MI to treatment as usual (TAU). Participants were recruited during their appointments with headache specialists at two sites of a New York City medical center. INCLUSION CRITERIA: ages from 16 to 80, migraine diagnosis by United Council of Neurologic Subspecialty fellowship trained and/or certified headache specialist, and referral for behavioral therapy for prevention in the appointment of recruitment. EXCLUSION CRITERIA: having done behavioral therapy for migraine in the past year. Participants in the MI group received up to 5 MI calls. TAUparticipants were called after 3 months for general follow-up data. The prespecified primary outcome was scheduling a behavioral therapy appointment, and secondary outcomes were initiating and attending a behavioral therapy appointment. RESULTS: 76 patients were enrolled and randomized (MI = 36, TAU = 40). At baseline, the mean number of headache days was 12.0 ± 9.0. Self-reported anxiety was present for 36/52 (69.2%) and depression for 30/52 (57.7%). Follow-up assessments were completed for 77.6% (59/76, MI = 32, TAU = 27). The mean number of MI calls per participant was 2.69 ± 1.56 [0 to 5]. There was a greater likelihood of those in the MI group to initiating an appointment (22/32, 68.8% vs 11/27, 40.7%, P = .0309). There were no differences in appointment scheduling or attendance. Reasons stated for not initiating behavioral therapy were lack of time, lack of insurance/funding, prioritizing other treatments, and travel plans. CONCLUSIONS: Brief telephone-based MI may improve rates of initiation of behavioral therapy for migraine, but other barriers appear to lessen the impact on scheduling and attending behavioral therapy appointments.
Authors: Mia T Minen; Neil A Busis; Steven Friedman; Maya Campbell; Ananya Sahu; Kazi Maisha; Quazi Hossain; Mia Soviero; Deepti Verma; Leslie Yao; Farng-Yang A Foo; Jaydeep M Bhatt; Laura J Balcer; Steven L Galetta; Sujata Thawani Journal: Digit Health Date: 2022-07-17
Authors: Mia T Minen; Sarah Corner; Thomas Berk; Valeriya Levitan; Steven Friedman; Samrachana Adhikari; Elizabeth B Seng Journal: Gen Hosp Psychiatry Date: 2021-01-07 Impact factor: 3.238
Authors: Donna Langenbahn; Yuka Matsuzawa; Yuen Shan Christine Lee; Felicia Fraser; Donald B Penzien; Naomi M Simon; Richard B Lipton; Mia T Minen Journal: J Gen Intern Med Date: 2021-02-01 Impact factor: 5.128
Authors: Mia T Minen; Samrachana Adhikari; Jane Padikkala; Sumaiya Tasneem; Ashley Bagheri; Eric Goldberg; Scott Powers; Richard B Lipton Journal: Headache Date: 2020-11-16 Impact factor: 5.887