Improving Health Outcomes of Migraine Patients Who Present to the Emergency Department

2016-10-27 05:38:22 | BioPortfolio


Collectively, evidence shows that a combination of medication and behavioral therapy is most effective for migraine care. The ED is a critical point of contact with the health care system for many migraine patients; in current practice, it is a missed opportunity to initiate and establish a comprehensive migraine management paradigm. Behavioral headache treatments (e.g., progressive muscle relaxation (PMR), biofeedback, cognitive-behavioral therapy (CBT)) are effective migraine treatment options that are essentially free of side effects. PMR has also been successful as a technique that patients can do independently. Studies have shown that combination pharmacological-behavioral therapy is most effective for migraine treatment.

Several aspects of this study are innovative, including: 1. Initiation of preventive medication in a timely manner for migraineurs who present to the ED. 2. Introduction of PM+PMR in the ED at a time that can serve as a teachable moment. 3. Introduction of a smartphone application-based product (a minimal contact based behavioral therapy) in the ED setting to reduce headache disability, frequency, and intensity.


Investigators will conduct a randomized trial to evaluate the impact of a comprehensive migraine treatment program on the quality of life for migraineurs with frequent and disabling headaches who present to the ED. The intervention (PM+PMR) will combine acute treatment, migraine preventive medication-topiramate, and the APP with PMR. Data from patients in the intervention group will be compared with data from an enhanced usual care (EUC) group to examine the efficacy of the combined treatment effects.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment




Preventative Medication (PM) Topiramate, Naproxen or Triptan, Enhanced Usual Care, PMR (progressive muscle relaxation therapy)


New York University School of Medicine
New York
New York
United States


Not yet recruiting


New York University School of Medicine

Results (where available)

View Results


Published on BioPortfolio: 2016-10-27T05:38:22-0400

Clinical Trials [2685 Associated Clinical Trials listed on BioPortfolio]

Migraine Treatment in ED

Randomized pilot feasibility study evaluating the impact of introducing behavioral treatment for migraine in the Emergency Department (ED) and prescribing migraine preventive medications i...

An Open-label Study to Evaluate Topiramate Therapy in Migraine Patients, and Its Effects on Subject Responsiveness to Migraine Treatment With Triptans

The purpose of this study is to evaluate whether prophylactic use of topiramate (preventative use before a migraine attack) enhances the effectiveness of migraine treatment with triptans.

"Completeness of Response" Following Treatment With Treximet™ for Migraine

Many clinical trials may not fully explore criteria that are important to some migraine patients' definition of "complete response." This study offers the opportunity to evaluate the effe...

Identifying Factors Underlying the Discontinuation of Triptans

The objective of this study is to identify reasons migraine patients stop using triptan medications for abortive headache treatment. It is hypothesized that inadequate education of the pat...

Topiramate to Reduce Cocaine Dependence

Cocaine addiction is a serious health problem with no available medical treatment for preventing relapse. Topiramate, a medication which lowers dopamine levels, may have the ability to dim...

PubMed Articles [16039 Associated PubMed Articles listed on BioPortfolio]

Topiramate Treatment of Alcohol Use Disorder in Clinical Practice.

: Topiramate is an anticonvulsant medication with increasingly strong evidence, supporting its use for treating alcohol use disorder (AUD) based on clinical trials. These clinical cases summarize the ...

Topiramate Pharmacotherapy for Alcohol Use Disorder and Other Addictions: A Narrative Review.

: Topiramate is a non-benzodiazepine anticonvulsant medication with multi-faceted pharmacologic action. It has emerged as an efficacious pharmacotherapeutic option for the treatment of addiction, espe...

Osteopathic care for low back pain and neck pain: A cost-utility analysis.

The aim was to examine the health and economic consequences of osteopathic care for low back pain and neck pain in addition to usual care compared to usual care alone.

A shared medication scheme for community dwelling older patients with polypharmacy receiving home health care: role of the community pharmacist.

An accurate medication scheme may be a useful tool to improve medication safety in primary care. This study aimed to identify (1) pharmacists' alterations to nurse medication schemes and (2) potential...

Impulsiveness as a predictor of topiramate response for cocaine use disorder.

Topiramate has been studied in the treatment of substance use disorders and is often used off-label in the treatment of other disorders with impaired impulse control. We sought to determine whether im...

Medical and Biotech [MESH] Definitions

Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.

Organization of medical and nursing care according to the degree of illness and care requirements in the hospital. The elements are intensive care, intermediate care, self-care, long-term care, and organized home care.

The formal process of obtaining a complete and accurate list of each patient's current home medications including name, dosage, frequency, and route of administration, and comparing admission, transfer, and/or discharge medication orders to that list. The reconciliation is done to avoid medication errors.

Overall systems, traditional or automated, to provide medication to patients in hospitals. Elements of the system are: handling the physician's order, transcription of the order by nurse and/or pharmacist, filling the medication order, transfer to the nursing unit, and administration to the patient.

Approach to improve the quality of care by selectively encouraging or discouraging the use of specific health care services, based on their potential benefit to patients' health, relative to their cost. One element is lowering beneficiary cost sharing or out-of-pocket spending to increase medication adherence.

More From BioPortfolio on "Improving Health Outcomes of Migraine Patients Who Present to the Emergency Department"

Quick Search


Relevant Topics

Pharmacy is the science and technique of preparing as well as dispensing drugs and medicines. It is a health profession that links health sciences with chemical sciences and aims to ensure the safe and effective use of pharmaceutical drugs. The scope of...

Neurology - Central Nervous System (CNS)
Alzheimer's Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology Pain Parkinson's Disease Sleep Disorders Neurology is the branch of me...

Searches Linking to this Trial