Smartphone Use Restriction as Treatment of Primary Headache

Study description:

Patients/participants:

• Patients ≥18 years of age
• Diagnosis of primary headache as per the ICHD3Beta classification ("ICHD-3 The International Classification of Headache Disorders 3rd Edition" n.d.)
• Willing and consenting to participate in the study. Patients will be first asked about their smartphone use.

• If they do not use smartphone, they will be asked if they use any phone at all for calling, and their call durations will be recorded over the run-in and study period.
• If they do not use any phone, they will fall in the external control group (Arm A).
• If the patient uses a feature phone, but not a smartphone, he/she will be in another external control group (Arm B). These patients will not be randomized, but will be maintained on routine follow-up.
• If they use smartphone their use will be recorded over the study period in terms of:

o Screen use: Social network/testing/gaming/surfing/reading/music/video

• The smartphone users may further be classified into low and high smartphone users depending upon the smartphone addiction questionnaire (SAQ): usage score. SUs with 0-1 score on the SAQ were further grouped into low SUs, and patients with score ≥1 were grouped into high SUs. To create a homogenous group, only patients with high SU will be randomized to standard treatment (Arm C) and smartphone restriction group (Arm D).

Patients with headache with history of high smartphone use will be randomized into restriction and no-restriction arm.

Restriction method:

In the 'run-in' period of four weeks, the smartphone usage will be assessed in terms of number of overall use. The patients will then be advised to cut down the usage by one-third in terms of usage hours. The compliance will be checked at the time of outcome assessment.

Comparison:

In the non-intervention group only the smartphone usage data will be collected in the study period. The non-smartphone users will be as another control arm.

Outcome:

Primary:

The number of times the patient is using acute pain medications for headache per month, within three months after initiation of study period.

Secondary:

• The frequency of headache over a period of one month, three months after the initiation of study period in the intervention versus control group.
• The number of prophylaxis medications being taken three months after the initiation of study period in the intervention versus control group.

Timeline of measuring outcome:

The follow up will be over a period of 20 weeks after screening eligibility and 16 weeks after randomization. The patient will maintain a headache diary in which he/she will enter the number of times they needed to take rescue medication.

Inclusion criteria

• Patients ≥18 years of age
• Diagnosis of primary headache as per the ICHD3Beta classification ("ICHD-3 The International Classification of Headache Disorders 3rd Edition" n.d.)
• Willing and consenting to participate in the study.

Exclusion criteria

• 1. Secondary headaches 2. Not consenting for participation or follow up