The purpose of this study is to test whether telephone-based MI improves initiation and adherence to behavioral therapy for migraine prevention.  

Relaxation, biofeedback, and cognitive behavioral therapy are considered grade-A, evidence based behavioral treatments for migraine, the second most disabling condition (GBD). Despite the effectiveness of these behavioral treatments, prior research shows that patients do not pursue or adhere to the therapy suggested by their headache specialists. Motivational interviewing (MI) is a widely used method to help patients explore and overcome ambivalence to enact positive change in their lives. 

Randomized controlled trial during which participants were consecutively recruited during their appointments with headache specialists at NYU Langone Health. Inclusion criteria for this study were as follows: between age 16-80, formal migraine diagnosis by the headache specialist, and referral for behavioral therapy for migraine prevention in the appointment during which participants were recruited. Those in the MI group receive up to 5 MI calls. Both groups receive a general follow-up call 3-months after enrollment. 

Of the 81 patients who met inclusion criteria, 40 patients were randomized into the MI group, and 41 into the control group. The mean age was 39 [SD=12].  Of our interim results, of those within the MI group, within the first month of enrollment, 9/29 (31%) reached by phone made an initial appointment. Reasons stated for not initiating behavioral treatment included: lack of time, lack of insurance/funding, confidence with current treatment, testing other treatments first, and travel plans. 

Despite the previously supported effectiveness of behavioral treatment, the results of this study demonstrate a continued resistance to pursue behavioral therapy. Future results and research will help inform how to improve uptake of these safe, efficacious, behavioral therapies.