Departments of Neurology and Population Health, NYU Langone Health, New York, NY, USA.
Department of Psychology, City College of New York Ringgold Standard Institution, New York, NY, USA.
Headache. 2020 Jun;60(6):1093-1102. doi: 10.1111/head.13790. Epub 2020 Mar 23.
There are safe and well-tolerated level A evidence-based behavioral therapies for the prevention of migraine. They are biofeedback, cognitive behavioral therapy, and relaxation. However, the behavioral therapies for the prevention of migraine are underutilized.
We sought to examine whether people with migraine with 4 or more headache days a month had preferences regarding the type of delivery of the behavioral therapy (in-person, smartphone based, telephone) and whether they would be willing to pay for in-person behavioral therapy. We also sought to determine the predictors of likelihood to pursue the behavioral therapy.
Using a cross-sectional study design, we developed an online survey using TurkPrime, an online survey platform, to assess how likely TurkPrime participants who screened positive for migraine using the American Migraine Prevalence and Prevention screen were to pursue different delivery methods of the behavioral therapy. We report descriptive statistics and quantitative analyses.
There were 401 participants. Median age was 34 [IQR: 29, 41] years. More than two thirds of participants (70.3%, 282/401) were women. Median number of headache days/ month was 5 [IQR: 2.83, 8.5]. Some (12.5%, 50/401) used evidence-based behavioral therapy for migraine. The participants reported that they were "somewhat likely" to pursue in-person or smartphone behavioral therapy and behavioral therapy covered by insurance but were neutral about pursuing the telephone-based behavioral therapy. Participants were "not very likely" to pay out of pocket for the behavioral therapy. Migraine-related disability as measured by the MIDAS grading score was associated with likelihood to pursue the behavioral therapy in-person (P = .004), via telephone (P = .015), and via smart phone (P < .001), and covered by insurance (P = .001). However, migraine-related disability was not associated with likelihood to pursue out of pocket (P = .769) behavioral therapy. Pain intensity was predictive of likelihood of pursuing the behavioral therapy for migraine when covered by insurance. Other factors including education, employment, and headache days were not predictors.
People with migraine prefer in-person and smartphone-based behavioral therapy to telephone-based behavioral therapy. Migraine-related disability is associated with likelihood to pursue the behavioral therapy (independent of type of delivery of the behavioral therapy-in-person, telephone based or smartphone based). However, participants were not very likely to pay for the behavioral therapy.
有安全且耐受良好的 A 级循证行为疗法可预防偏头痛。它们是生物反馈、认知行为疗法和放松。然而，预防偏头痛的行为疗法并未得到充分利用。
我们试图研究每月有 4 天或以上头痛天数的偏头痛患者对行为疗法（面对面、基于智能手机、电话）的传递方式是否有偏好，以及他们是否愿意为面对面的行为疗法付费。我们还试图确定进行行为疗法的可能性的预测因素。
使用横断面研究设计，我们使用 TurkPrime 开发了一个在线调查，这是一个在线调查平台，以评估使用美国偏头痛患病率和预防筛查筛查出偏头痛阳性的 TurkPrime 参与者对不同行为疗法传递方式的追求意愿。我们报告描述性统计数据和定量分析。
共有 401 名参与者。中位年龄为 34 岁[IQR：29，41]岁。超过三分之二的参与者（70.3%，282/401）为女性。中位每月头痛天数为 5 天[IQR：2.83，8.5]。一些（12.5%，50/401）使用了偏头痛的循证行为疗法。参与者报告说，他们“有些可能”会选择面对面或基于智能手机的行为疗法以及保险覆盖的行为疗法，但对电话为基础的行为疗法持中立态度。参与者“不太可能”自费接受行为疗法。偏头痛相关残疾的严重程度（MIDAS 分级评分）与面对面（P=0.004）、通过电话（P=0.015）和通过智能手机（P<0.001）以及保险覆盖（P=0.001）进行行为疗法的可能性相关。然而，偏头痛相关残疾与自费（P=0.769）行为疗法的可能性无关。疼痛强度是预测当保险覆盖时偏头痛患者接受行为疗法的可能性的因素。其他因素，包括教育、就业和头痛天数，都不是预测因素。
偏头痛患者更喜欢面对面和基于智能手机的行为疗法，而不是基于电话的行为疗法。偏头痛相关残疾与行为疗法的可能性相关（独立于行为疗法的传递方式-面对面、电话或基于智能手机）。然而，参与者不太可能为行为疗法付费。
