Despite the fact that more than 10% of Americans suffer from migraine, this headache disorder is often not diagnosed and not appropriately treated. The goal of this proposal is to determine whether a migraine protocol designed for use in an emergency room can be used to deliver the headache care that many migraine patients never receive. This is a randomized trial. Consecutive inadequately treated migraine patients will be randomized to TYPICAL care or to COMPREHENSIVE care. Those patients in the comprehensive care arm will receive the following intervention: 1) reinforcement of diagnosis, 2) an adaptable online educational intervention, reading material, and headache diaries, 3) two migraine specific medications and 4) expedited referral to a headache specialist, if needed. Patients in the typical care arm will receive whatever intervention the emergency physician feels is most appropriate. Headache surveys will be used toll if the protocol improves migraine-related pain and functional disability one month after the ER visit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
50
Naproxen 500mg PO bid prn headache
100mg po q day prn headache
Educational program available through NIH/ national library of medicine/ X-plain
Patient advised has migraine headache and how the headache meets migraine criteria
Care to be determined by attending physician
Montefiore Medical Center
The Bronx, New York, United States
Migraine Functional Impairment as Measured by Score on the Headache Impact Test 6 (HIT6) Scale
This is a standardized instrument commonly used in migraine research. Participants answer 6 Likert questions about the impact of migraine on their daily life. A score of 36, the lowest possible score, indicates minimal functional impairment. A score of 78, the highest possible score, indicates substantial functional impairment
Time frame: 1 month after study enrollment
Number of Participants Who Report Satisfaction With Treatment, as Measured by a Three Item Likert Scale
Participants could report that they were completely satisfied, mostly satisfied or unsatisfied. Reported here are the number who were unsatisfied.
Time frame: 1 month after study enrollment
Number of Participants Who Report They Are Comfortable With Disease Management, as Measured by a Three-item Likert Scale
Participants were asked to describe themselves as very comfortable, somewhat comfortable, or uncomfortable. Reported here are those who were very comfortable
Time frame: 1 month after study enrollment
Number of Participants Who Returned to the Emergency Department for Management of Headache
We report the number of patient who returned to the emergency department for management of headache
Time frame: 1 month after study enrollment
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