Because there is no known cure for migraine, treatment focuses on the prevention and management of migraine attacks through medication and behavioral treatments. Existing migraine treatment research has focused on treatment outcome in terms of headache reduction, but has failed to fully assess migraine sufferers’ continued use of migraine management skills taught during pharmacological and behavioral treatments (Reid & McGrath, 1996). In an effort to better capture the migraine management skills used by individuals who receive Behavioral Migraine Management (BMM), preventive medication (PM), and their combination, the present study expanded on the efforts of previous longitudinal migraine treatment studies by collecting data on use of migraine management techniques at several time points during and after treatment via structured interview (Interview of Coping Efforts – Migraine, ICE-M, Hill, 2003). Unlike previous measures, the ICE-M (1) used open ended questions to assess migraine management techniques taught during treatment as well as capture novel techniques, (2) identified the phase of migraine at which each headache management technique was used, and (3) categorized each migraine management technique as either positive (active behaviors such as problem solving or progressive muscle relaxation) or palliative (avoidant or passive behaviors such as isolation in a dark room, use of hot/cold packs). A secondary purpose was to assess migraine-related disability and health related quality of life as possible moderators between treatment and use of migraine management techniques.
Mixed models analyses revealed that BMM increased the use of positive migraine management techniques to prevent migraines, in anticipation of a migraine and while managing a migraine episode. BMM and PM helped to decrease the use of palliative migraine management techniques in anticipation of migraines and BMM served to decrease use of palliative techniques in managing the migraine episode. Additional analyses demonstrated that, at the anticipatory stage, health-related quality of life serves as a moderator of PM and palliative migraine management techniques so that participants with a lower quality of life at baseline reported greater decreases in palliative techniques. Taken together, the pattern of changes in migraine management suggests that providing behavioral migraine management interventions can affect how migraine sufferers manage their migraines.