Internet-delivered psychological treatment program for adults with frequent migraines: a randomized controlled pilot study with a mixed methods design.

Marie Peersson

Keywords: IKBT, migraine, pain,

Background:

An internet-delivered psychological treatment program called Internet Approach to Migraine (I AM), based on a pain perspective, was developed in 2021 in the Västra Götaland region in western Sweden. Migraines are episodic and recurring conditions in individuals who are often symptom-free between attacks, but when migraine attacks become frequent, there is a risk of developing chronic migraine.

Research questions:

The purpose of the study was to evaluate the feasibility, acceptance, and initial treatment effects of I AM, when used in conjunction with standard medical treatment (TAU) for migraine patients in Swedish primary healthcare settings.

Method:

The pilot study was a randomized controlled treatment study with a mixed-methods convergent parallel design. Twenty nine participants were randomly assigned to one of two treatment conditions: (1)
therapist-guided internet-based psychological treatment in combination with usual medical
treatment (TAU) or (2) TAU in primary care.

Results:

Seventy-two percent of the 29 participants completed both baseline and 3-month follow-up measures. On average, participants completed 7.7 modules, with 60% completing all 10 modules. Promising effect size indicated a reduction in migraine days during the three-month follow-up.
Interviews with participants (n = 7) indicate that most participants had struggled with migraines for decades and expressed dissatisfaction with the limited medical care. They found the flexible, digital format particularly helpful, praising its accessibility and structured learning. While they appreciated the comprehensive content, some faced challenges with the psychological language and the program pace. Post-treatment, participants reported emotional and behavioral changes, and better migraine management.

Conclusions:

Both qualitative and quantitative data support the feasibility and acceptability of the intervention in primary care settings.
To our knowledge, this is the first randomized controlled trial (RCT) to investigate an internet-based psychological treatment for patients with migraine in primary health care in Sweden.

Points for discussion:

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