TelemEdiciNe-bAsed Cognitive TherapY for Migraines

Launched by VA OFFICE OF RESEARCH AND DEVELOPMENT · Oct 27, 2020

Keywords

ClinConnect Summary

With VHA's infrastructure dedicated to efficient telehealth delivery into patient homes, the delivery of a behavioral intervention for chronic migraine, CM, via the telehealth platform is primed to address barriers of in-person care delivery and holds considerable promise to reach and improve Veteran headache-related quality of life. Therefore, the goal is to evaluate an adapted bundle of EB implementation strategies to increase adoption of a Telemedicine-based Cognitive Behavioral Therapy (CBT) program (TENACITY) for CM in 2 VA HCoEs (VA Connecticut Healthcare System \[VACHS\], a large, mu...

Gender

ALL

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