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NCT05889624 | RECRUITING | Headache


Responding With Evidence and Access for Childhood Headaches
Sponsor:

Children's Hospital Medical Center, Cincinnati

Brief Summary:

This comparative effectiveness study will clarify current first-line preventive treatment approaches for use by neurologists, psychologists, and primary care providers in the context of real world care, and will demonstrate the feasibility of Cognitive Behavioral Therapy (CBT) via telehealth for youth with migraine. The focus is on applying evidence-based care and enhancing access to it. CBT via telehealth while taking a clinically-prescribed, pill-based prevention therapy (amitriptyline) will be compared to CBT via telehealth alone.

Condition or disease

Headache

Headache Disorders

Headache, Migraine

Migraine

Migraine Disorders

Migraine With Aura

Migraine Without Aura

Chronic Migraine

Intervention/treatment

CBT

Amitriptyline

Phase

NA

Detailed Description:

Migraine is the second most disabling disease in the world. Research has primarily focused on treating migraine in adults; however, approximately 10% of children and adolescents have migraine, suggesting that up to 7 million youth are impacted in the United States alone. Given that the majority of youth have migraine symptoms that persist into adulthood, there is a critical need to identify and improve access to the most effective preventive migraine treatments for this population as a means of reducing the long-term healthcare burden and functional impairment of this illness. This comparative effectiveness study will test CBT while taking a clinically-prescribed, pill-based prevention therapy (amitriptyline) to CBT alone. Participants will be involved in the study for approximately 28 weeks, with the first 4 weeks being a baseline period and the next 8 weeks involving six telehealth CBT sessions for both study groups (CBT while taking a clinically-prescribed pill-based prevention therapy \[amitriptyline\] compared to CBT alone), and dose titration of clinically-prescribed medication (amitriptyline) for the CBT + clinically-prescribed, pill-based prevention therapy (amitriptyline) group. During the remaining 16 weeks the participants will maintain the dose of medication (in the CBT + clinically-prescribed, pill-based prevention therapy (amitriptyline) group) and attend "booster" CBT sessions held three times over 4 months.

Study Type : INTERVENTIONAL
Estimated Enrollment : 400 participants
Masking : SINGLE
Masking Description : Only the principal investigator will remain blinded to the randomization assignment. All other study staff including the project manager, assistant project manager, study statistician, site investigators and study staff, participants, and their parents will be aware of the treatment assignment.
Primary Purpose : TREATMENT
Official Title : Cognitive Behavioral Therapy Via Telehealth + Amitriptyline Compared to Cognitive Behavioral Therapy Via Telehealth: Pediatric Migraine Prevention (Responding With Evidence and Access for Childhood Headaches)
Actual Study Start Date : 2023-08-22
Estimated Primary Completion Date : 2027-07-31
Estimated Study Completion Date : 2027-12-31

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 10 Years to 17 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Diagnosis: Migraine with or without aura that meets the International Classification of Headache Disorders (ICHD) criteria 5 or presentation of continuous headache that includes migranous episodes based upon headache history obtained by site PI or designee. (includes presentation with or without medication overuse headache as well)
  • * Headache Frequency: 4 or more headache days based upon prospective headache diary of 28 days prior to randomization
  • * Amitriptyline Eligible: Site PI or medical staff determined participant to be eligible for clinical prescription of amitriptyline as a preventive treatment for migraine
  • * English fluency: Able to complete the study visits and questionnaires in English
Exclusion Criteria
  • * Current treatment includes amitriptyline and/or CBT specific to headache care
  • * Current prescribed preventive antimigraine medication within a period equivalent to \< 5 half-lives of that medication before entering the baseline phase
  • * Current treatment with onabotulinumtoxinA (Botox) or CGRP-based monoclonal antibody medications for migraine prevention
  • * Youth who are pregnant
  • * Report of current or ongoing suicidal thoughts. Suicide attempt within the past six months. History of bipolar disorder, prolonged QT, or pre-existing significant constipation or gastroparesis
  • * Any and all other diagnoses or conditions which, in the opinion of the site investigator, would prevent the patient from being a suitable candidate for the study or interfere with the medical care needs of the participant

Responding With Evidence and Access for Childhood Headaches

Location Details

NCT05889624


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How to Participate

Want to participate in this study, select a site at your convenience, send yourself email to get contact details and prescreening steps.

Locations


RECRUITING

United States, alabama

University of Alabama at Birmingham Children's of Alabama

Birmingham, alabama, United States, 35233

RECRUITING

United States, Arizona

Phoenix Children's Hospital - Barrow Neurological Institute

Phoenix, arizona, United States, 85016-7710

RECRUITING

United States, California

University of California San Francisco

San Francisco, California, United States, 94115

RECRUITING

United States, Colorado

University of Colorado/Children's Hospital Colorado

Aurora, Colorado, United States, 80045

RECRUITING

United States, Delaware

Nemours Children's Health System

Wilmington, Delaware, United States, 19810

RECRUITING

United States, Georgia

Clinical Integrative Research Center of Atlanta, Inc

Atlanta, Georgia, United States, 30328

RECRUITING

United States, Kentucky

University of Louisville Health/Norton

Louisville, Kentucky, United States, 40292

RECRUITING

United States, Louisiana

Louisiana State Univ/Children's Hospital of New Orleans

New Orleans, Louisiana, United States, 70118-5720

RECRUITING

United States, New York

Dent Neurological Institute

Amherst, New York, United States, 14226

RECRUITING

United States, Ohio

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States, 45229

RECRUITING

United States, Ohio

Nationwide Childrens

Columbus, Ohio, United States, 43205

RECRUITING

United States, Pennsylvania

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States, 19104

RECRUITING

United States, Tennessee

University of Tennessee Health Science Center/ LeBonheur Children's Hospital

Memphis, Tennessee, United States, 38103

RECRUITING

United States, Texas

Dell Children's Hospital-UT Health

Austin, Texas, United States, 78712

RECRUITING

United States, West Virginia

Marshall Health

Huntington, West Virginia, United States, 25701

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