Combining Guided Intervention of Education and Relaxation (GIER) with Remote Electrical Neuromodulation (REN) in the Acute Treatment of Migraine.
Document Type
Article
Publication Date
8-31-2022
Identifier
DOI: 10.1093/pm/pnac021
Abstract
BACKGROUND: Evidence indicates that combining behavioral treatments with pharmacological treatments for migraine prevention improves efficacy, but little is known about the outcomes of combining neuromodulation and behavioral interventions for acute treatment of migraine. Remote electrical neuromodulation (REN) is a U.S. Food and Drug Administration (FDA)-cleared nonpharmacological migraine treatment. The present study evaluated the clinical benefits of augmenting REN treatment with a specially tailored behavioral therapy consisting of Guided Intervention of Education and Relaxation (GIER) for the acute treatment of migraine.
METHODS: In this two-arm observational study, real-world data were collected from patients across the United States who were using the REN device. Eighty-five migraine patients ≥18 years of age who treated their attacks with REN in parallel with the GIER intervention were individually matched on age and sex with 85 patients who used REN alone. The groups were compared on the proportion of migraine attacks in which they achieved pain relief, pain freedom, improvement of function, and return to normal function, all at 2 hours after treatment.
RESULTS: Data from 170 users were analyzed (85 per group). Compared with the REN-only group, the REN+GIER group displayed a statistically significant higher proportion of patients achieving consistent pain relief (P = 0.008), consistent improvement in function (P = 0.014), and consistent return to normal function (P = 0.005), all at 2 hours after treatment.
CONCLUSIONS: The results suggest that combining the GIER behavioral intervention with REN treatment can improve the therapeutic efficacy beyond that of REN alone, in terms of both pain level and improvement of disability.
Journal Title
Pain medicine (Malden, Mass.)
Volume
23
Issue
9
First Page
1544
Last Page
1549
MeSH Keywords
Administration, Oral; Humans; Migraine Disorders; Pain Management; Treatment Outcome
Keywords
Behavioral; Digital Therapeutics; Headache; Migraine; Nerivio; Remote Electrical Neuromodulation
Recommended Citation
Buse DC, Rabany L, Lin T, Ironi A, Connelly MA, Bickel JL. Combining Guided Intervention of Education and Relaxation (GIER) with Remote Electrical Neuromodulation (REN) in the Acute Treatment of Migraine. Pain Med. 2022;23(9):1544-1549. doi:10.1093/pm/pnac021
COinS
Comments
Grant support