Migraine headache is a common, chronic medical condition characterized by recurrent attacks of pain, disability, emotional distress, and loss of productivity that affects approximately 18% of women and 6.5% of men in the United States, an estimated 28 million Americans. Diagnosis and treatment of migraine is complex. Traditional treatment approaches have met with varied success, tending to """"""""medicalize"""""""" patients, placing them in a passive role, with limited emphasis on active self-management. Only half of migraineurs are satisfied with their current care, and over 90% wish they could prevent their headaches (Wenzel et al., 2004a). A critical component of effective treatment is engaging the patient in self-management so they can learn how to identify, avoid, and manage headache triggers and engage in other critical headache management behaviors. Accessible help is needed to facilitate patient education and engagement in the adoption of behavioral self-management skills. The Internet is an excellent vehicle for helping migraineurs manage their headaches, but existing migraine Websites don't offer a tailored interactive experience and many are simply long, text-filled pages, offering no audio and limited graphical support. Some profess """"""""cures"""""""" but offer information of questionable scientific validity. No migraine Websites have been tested to see how much they help patients improve headache management and attain symptom reduction. This proposal calls for the development of an interactive Website called ManageMyMigraine to provide up-to-date information about diagnosis, treatment, and management of migraine headache, designed for consumers. The site will engage users with many unique interactive features like self-assessments with tailored feedback, self-management recommendations that address patient priorities and problems, interactive tools for tracking individualized patient data (triggers, preventive strategies, medication usage, and side effects), and for monitoring progress in reducing headache frequency, managing symptoms, and engaging in preventive efforts. Individual data will be printable so that users can share it with their providers. While tailored interactive Websites are slowly becoming available, no migraine Website currently offers this combination of self-management support; interactive content, features, and tools; and tailored, individualized messaging to engage and support site users. Migraine related disability can be reduced by making behavioral support available in a more timely way for larger numbers of people. A focus on both medical and behavioral intervention, makes ManageMyMigraine a significantly innovative advance in migraine care, and holds the promise of helping migraineurs manage their condition more effectively, avoid disease progression, and reduce the high cost of migraine to individuals and society. Migraine headache is a common yet poorly managed illness and medically unrecognized migraine remains an important public health problem. Accurate recognition and effective treatment of migraine are critical when we consider the prevalence of migraine and the individual and societal costs associated with this disorder. There is a great need to educate the population about behavioral self-management of migraine. ManageMyMigraine, will provide user-tailored, interactive education and tracking tools for helping patients record and organize key clinical data to assist providers in more accurately assessing migraine disability and response to medical treatment. The site will serve as a psych-social adjunct to appropriate medical treatment. A focus on both medical and behavioral intervention, makes ManageMyMigraine a significantly innovative advance in migraine care, and holds the promise of helping migraineurs manage their condition more effectively, avoid disease progression, and reduce the high cost of migraine to individuals and society. ? ? ?
| Bromberg, Jonas; Wood, Mollie E; Black, Ryan A et al. (2012) A randomized trial of a web-based intervention to improve migraine self-management and coping. Headache 52:244-61 |
