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Multisite Advancement of Research on Chronic Posttraumatic Headache
Sponsor: The University of Texas Health Science Center at San Antonio
Summary
Posttraumatic headache (PTH) is a common and highly disabling consequence of traumatic brain injury (TBI) in U.S. military service members and veterans. Cognitive Behavioral Therapy for PTH has been shown to significantly improve disability outcomes in veterans with persistent PTH when delivered in-person. Telemedicine platforms can dramatically increase access to evidence-based care. However, whether CBT for PTH retains its effectiveness when delivered through a telemedicine platform has yet to be established. The purpose of this 3-arm randomized clinical trial is to compare Clinic-based Cognitive-Behavioral Therapy (CCBT) to Telemedicine-based Cognitive Behavioral Therapy (TCBT) and to treatment as usual (TAU) in 525 service members and veterans with chronic posttraumatic headaches (PTH) at 4 VA medical centers\* and 3 military treatment facilities across the U.S. Participants will be assessed for headache-related disability, headache experience, and psychiatric comorbidities across multiple time points. \*VA Palo Alto Health Care System is temporarily randomizing into TAU and TCBT only.
Official title: Project MARCH: Multisite Advancement of Research on Chronic Posttraumatic Headache
Key Details
Gender
All
Age Range
18 Years - 70 Years
Study Type
INTERVENTIONAL
Enrollment
525
Start Date
2023-08-24
Completion Date
2027-08
Last Updated
2026-01-20
Healthy Volunteers
No
Conditions
Interventions
Cognitive Behavioral Therapy for Posttraumatic Headache
CBT for Posttraumatic Headaches consists of 8 sessions of cognitive behavioral therapy that focus on (1) discussions and exercises that increase awareness of what may be related to headaches, (2) relaxation techniques to manage physiological stress, and (3) problem-solving techniques to manage common stressors. Sessions are delivered weekly and can last between 45 to 75 minutes based on clinical content and patient response to the material.
Treatment as Usual
Participants will continue to engage in medical care as usual for 8 weeks.
Telemedicine-based Cognitive Behavioral Therapy (TCBT)
Participants assigned to TCBT will receive 8 sessions of cognitive behavioral therapy using telemedicine rather than face-to face office visits.
Locations (8)
VA Greater Los Angeles Healthcare System
Los Angeles, California, United States
VA Palo Alto Health Care System
Palo Alto, California, United States
Tripler Army Medical Center (Desmond Doss Health Clinic, Schofield Barracks)
Honolulu, Hawaii, United States
Walter Reed National Military Medical Center
Bethesda, Maryland, United States
Minneapolis VA Health Care System
Minneapolis, Minnesota, United States
Carl R. Darnall Army Medical Center (Fort Cavazos)
Killeen, Texas, United States
South Texas Veterans Health Care System
San Antonio, Texas, United States
Brooke Army Medical Center
San Antonio, Texas, United States