Electronic behavioral interventions for headache: a systematic review
Open accessAbstract
BACKGROUND: There is increasing interest in using electronic behavioral interventions as well as mobile technologies such as smartphones for improving the care of chronic disabling diseases such as migraines. However, less is known about the current clinical evidence for the feasibility and effectiveness of such behavioral interventions. OBJECTIVE: To review the published literature of behavioral interventions for primary headache disorders delivered by electronic means suitable for use outside of the clinician's office. METHODS: An electronic database search of PubMed, PsycINFO, and Embase was conducted through December 11, 2015. All eligible studies were systematically reviewed to examine the modality in which treatment was delivered (computer, smartphone, watch and other), types of behavioral intervention delivered (cognitive behavioral therapy [CBT], biofeedback, relaxation, other), the headache type being treated, duration of treatment, adherence, and outcomes obtained by the trials to examine the overall feasibility of electronic behavioral interventions for headache. RESULTS: Our search produced 291 results from which 23 eligible articles were identified. Fourteen studies used the internet via the computer, 2 used Personal Digital Assistants, 2 used CD ROM and 5 used other types of devices. None used smartphones or wearable devices. Four were pilot studies (N ≤ 10) which assessed feasibility. For the behavioral intervention, CBT was used in 11 (48 %) of the studies, relaxation was used in 8 (35 %) of the studies, and biofeedback was used in 5 (22 %) of the studies. The majority of studies (14/23, 61 %) used more than one type of behavioral modality. The duration of therapy ranged from 4-8 weeks for CBT with a mean of 5.9 weeks. The duration of other behavioral interventions ranged from 4 days to 60 months. Outcomes measured varied widely across the individual studies. CONCLUSIONS: Despite the move toward individualized medicine and mHealth, the current literature shows that most studies using electronic behavioral intervention for the treatment of headache did not use mobile devices. The studies examining mobile devices showed that the behavioral interventions that employed them were acceptable to patients. Data are limited on the dose required, long term efficacy, and issues related to the security and privacy of this health data. This study was registered at the PROSPERO International Prospective Register of Systematic Reviews (CRD42015032284) (Prospero, 2015).
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Evidence of the effectiveness of app-based behavioral interventions for managing headaches remains weak.
“However, evidence of the effectiveness of app-based behavioral interventions for managing headaches remains weak [44,47].”
Minen et al found that most studies using electronic behavioral interventions to treat headaches did not use mobile devices.
“Minen et al [44] found that, despite a trend toward mHealth, most studies using electronic behavioral interventions to treat headaches did not use mobile devices.”
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- Authors
- Minen, M. T., Torous, J., Raynowska, J., Piazza, A., Grudzen, C., Powers, S., Lipton, R., & Sevick, M. A.
- Affiliations
- NYU Langone Health (US)
- Brigham and Women's Hospital (US)
- New York University (US)
- Cincinnati Children's Hospital Medical Center (US)
- Albert Einstein College of Medicine (US)
- Corresponding author
- Minen, Mia Tova
- ORCID
- Venue
- The Journal of Headache and Pain
- Published
- 2016-05-10
- Volume
- 17
- Issue
- 1
- Pages
- 51-51
- ISSN
- 1129-2369 (ISSN-L)
- 1129-2377
- PMC
- PMC4864730
- OpenAlex
- W2345466571
- Cited by
- 58
- References
- 60
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 3 · 2021: 9 · 2020: 7 · 2019: 8 · 2018: 8 · 2017: 4
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Journal of Headache and Pain (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (NIH-K24-NR01226.)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- headache, migraine, primary headache, cognitive behavioral therapy, biofeedback, relaxation training, online therapy, feasibility, mobile health, wearable devices, smartphone-based intervention, medication adherence
- MeSH terms
- Adult, Feasibility Studies, Female, Headache, Humans, Male, Prospective Studies, Cognitive Behavioral Therapy, Internet, Computers, Handheld
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