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N/A N=57 Randomized Double-blind Health Services Research

TelemEdiciNe-bAsed Cognitive TherapY for Migraines

Migraine Headache

Enrolled (actual)
57
Serious AEs
7.0%
Results posted
Sep 2024
Primary outcome: Primary: Number of Headache Days at 3 Months — 18.17; 19.19; 16.47; 18.26 headache days — p=0.61

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
TENACITY Telehealth Cognitive Behavioral Therapy for Migraine (Behavioral); Behavioral Usual Care (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
VA Office of Research and Development
Primary completion
Apr 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Headache Days at 3 Months
18.17; 19.19; 16.47; 18.26 0.61
PRIMARY
Budget Impact Analysis - Cost of Training (Implementation)
12020.99; 271.57
PRIMARY
Budget Impact Analysis - Time
201.1; 4.0
PRIMARY
Budget Impact Analysis - Cost Per Veteran
194.46; 113.52

Summary

The goal of this pilot study is to evaluate a bundle of implementation strategies at three Veteran Affairs Medical Centers (VAMCs) to facilitate the referral and adoption of a telehealth based, cognitive behavioral therapy program delivered by Health Psychologists for Veterans with chronic migraine to inform a future fully-powered hybrid type 2 effectiveness-implementation design. Veteran patients will be randomized to either the telehealth delivered CBT or usual care. Headache symptoms and severity will be reported using a VA text messaging application.

Eligibility Criteria

Inclusion Criteria

Veteran patients eligible to participate must have:

  • A chronic migraine headache ICD-10 diagnosis;
  • Completion of at least 28 headache diary days;
  • A confirmed frequency of at least 8 headache days per month;
  • A primary complaint of headache

Exclusion Criteria

Veteran patients not eligible to participate include:

  • Non-Veterans;
  • Veteran patients without a CM headache ICD-10 diagnosis;
  • Veteran patients whose primary pain complaint is not headache;
  • Veteran patients who have received greater than or equal to 90 days of opioid therapy for chronic low back pain from the date of chart screening;
  • Veteran patients who do not speak English;
  • Veteran patients who have a current diagnosis of severe cognitive impairment indicated by clinical provider, medical chart, or Short Portable Mental Status Questionnaire (SPMSQ);
  • Veteran patients who have Post Traumatic headache;
  • Veteran patients who have a diagnosis of cluster headache, other primary headache, post-whiplash headache, secondary headache, or trigeminal autonomic cephalalgia.
  • Any patients currently suffering from a disabling psychiatric illness (as noted by clinician);
  • Veteran patients who self-report Traumatic Brain Injury less than or equal to 1 year before diagnosis of Chronic Migraine, or worsening of Chronic Migraine.
  • Veteran patients who relate daily suicidal ideation within the last 2 weeks as indicated by the PHQ-9 with an answer of "3" to question nine;
  • Veteran patients who have severe depression, as indicated by PHQ-9 score greater than or equal to 20;
  • Veteran patients who are deemed by clinicians who are unable to participate in this trial;
  • Patients who are terminally ill (life expectancy of <12 months as noted by clinician);
  • Patients who are homeless or live in long-term care, nursing home, rehabilitation, or domiciliary services, etc.
  • Veteran patients who decline to or cannot use the Annie App;
  • Veteran patients who decline to or cannot use My HealtheVet secure messaging
  • Veteran patients who have been treated by a HCoE clinical health psychologist in the last two years
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04613362). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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