The impact of neuroscience education therapy, behavioral economics, and digital navigators on patient migraine treatment adherence to a mobile health application: a prospective pilot randomized controlled trial
Abstract
Mobile health (mHealth) tools can be used to deliver nonpharmacologic therapies to patients with migraine. However, mHealth studies often report poor treatment adherence. Neuroscience Education Therapy (NET), behavioral economics, and Digital Navigators have the potential to increase treatment adherence and thereby improve remote migraine self-management. We conducted a 6-month prospective pilot randomized controlled trial testing if a multi-component package of behavioral interventions increased treatment adherence among patients using one of two different mHealth migraine self-management programs (low-intensity program consisting only of a headache diary versus high-intensity program consisting of a headache diary and behavioral exercises). Our outcomes were the number of diary entries and behavioral exercises completed/week captured via back-end analytics of the mHealth application. We also compared our adherence data at 90-days (a secondary endpoint to assess the durability of the effect) with adherence data from similar published studies without the adherence-enhancing package. We enrolled 26 participants (n = 15 low intensity group, n = 11 high-intensity group). During the 6-week intervention period, we had a median of 7 headache diary entries/week in both groups and a median of 6 days/week of behavioral exercises in the high-intensity group. The rate of adherence with the adherence-enhancing package included was 2.9-8x higher compared to the median rates of the…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 26 participants or records.
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