Learn More About: Self-Care Apps

Self-Care Apps and Digital Resources

Jill Lavigne, PhD

Learning Objectives

List 4 actions we can take to support Morgan as she explores digital self-management technologies.
Delineate the privacy issues about using web-based or wearable technologies or apps for the self-management of migraine.
List factors affecting the likelihood of adolescents using these technologies to manage migraine.

How should we address Morgan's interest in apps or web-based platforms for behavioral self-management?

Consider the following:

If, as you ask Morgan questions about her exposures to triggers and behaviors, she refers to the digital technology on her wrist and a link on her phone.
What would you say to Morgan in response to this use of digital technology for self-management?

Factors Affecting Technology Use

Given Morgan's routine use of her vlog, she may be interested in using apps or the web for self-management.
Like Morgan, adolescents with chronic migraine typically suffer reductions in functioning.
Most adolescents with chronic migraine had not visited a health care provider in the previous year.
Less than 1 in 5 reported taking medications to prevent headaches during the last month.
Low prevalence of chronic migraine in adolescents (<2%) suggests that teens may have little peer support to draw on when managing migraines and may turn to the Internet.

Reference

Minen M, Torous J, Raynowska J, Piazza A, Grudzen C, Powers, S, Lipton R, Sevick M. Electronic behavioral interventions for headache: a systematic review. The Journal of Headache and Pain, May 2016, Vol.17, pp.1-20.

We can support Morgan's love of digital technology by:

Encouraging her to focus on resources aimed at managing migraine triggers, including diet, sleep and stress.
Reminding her that these are adjunctive therapies, without clinical outcomes to support replacement of clinical care (e.g., CBT).
Cautioning Morgan and her mother that pharmaceutical and other companies may collect data for marketing or research purposes through these digital resources. A 2016 review found many unanswered questions about the privacy and security of data in these resources.
Asking Morgan to share with us any digital tools that she finds especially useful or concerning (just as we'd like to know about any supplements or diets she may try).

Which Tools to Use?

By 2016, >300 peer-reviewed articles described electronic self-management resources for headache, including migraine with and without aura in adolescents like Morgan.
Most were web-based and used a combination of methods (most commonly CBT, relaxation and biofeedback)
Feasibility and acceptability were addressed, but questions remain about dosing and long-term efficacy.