Clinical trial NCT02440997: A Preliminary Investigation of the Efficacy of Aromatherapy in Reducing Discomfort in Youth With Chronic Headache
Official title: A Preliminary Investigation of the Efficacy of Aromatherapy in Reducing Discomfort in Youth With Chronic Headache
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Chronic Headache
Migraine Headache
Headache
Keywords: aromatherapy, peppermint
Lead sponsor: Children's Mercy Hospital Kansas City
Sponsor class: OTHER
First posted: 2015-05-12
Enrollment: 46
Sex: ALL
Minimum age (years): 7
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to preliminarily establish the extent to which a brief aromatherapy intervention incrementally improves subjective and objective indicators of discomfort (pain, anxiety, and heart rate variability) beyond passive relaxation in youth with chronic headaches. A secondary objective is to establish the safety of using aromatherapy as a treatment strategy in youth with chronic headache. The investigators hypothesize that children randomized to the aromatherapy condition will demonstrate a greater improvement in pain, anxiety, and objectively measured distress (heart rate variability) than comparable children receiving only a passive relaxation treatment (a foot bath). The investigators further hypothesize that the aromatherapy intervention will be safe and well-tolerated by study participants.

Detailed description: Complementary and alternative therapies play an increasing role in the multidisciplinary treatment of primary pediatric headache disorders. Every pediatric headache patient needs to have a personalized and tailored program of education, psychological strategies, pharmacotherapy and complementary medicine choices. This particular study may prove desirable for parents of children and adolescents with chronic headache. As documented by Termine, C., Ferrari, Ginevra, O., D'Arrigo, S., Rossi, M., \& Lanzi, G. (2005), parents are often uncertain and fearful of submitting their children to treatment with traditional drugs, adolescents can use alternative therapies as a way of affirming their independence, and there are fewer drugs available to treat headache in children. Moreover, there is a 30-40% placebo response in headache sufferers (Mauskop, 2001). Children and adolescents should not be prevented from using alternative treatments, specifically essential oils, provided that the intervention is not harmful or costly. It is hoped this study will contribute to the scant research that exists and help define the indications, effects and limitations of aromatherapy use.

Eligibility criteria: Inclusion Criteria:

* • Male or female, children and adolescents age 7-17 years of age

  * Diagnosed with status migrainosus or refractory chronic daily headache according to the International Headache Society (ICHD-II) criteria. (A debilitating migraine lasting for more than 72 hours or a headache that lasts hours or may be continuous occurring on \> 15 days per month for \> 3 months.)
  * No prior history of aromatherapy / essential oil use
  * Able to read, comprehend and complete study procedures. Capable of reading and completing all subjective measures in English
  * Are sufficiently alert to be assessed and communicate
  * Must be compliant with routine medical care and able to perform study-related procedures
  * Provide written informed consent from parent/legal guardian and child assent in accordance with IRB regulations

Exclusion Criteria:

* • Known sensitivity to essential oils

  * History of cardiac fibrillation
  * History of G6PD deficiency
  * History of uncontrolled asthma (current, active wheezing)
  * History of diabetes, high blood pressure, epilepsy,
  * Inflammatory or sensory limitations of lower extremities or concurrent lesions of the foot(s)
  * Past or concurrent history of olfactory impairment
  * Concomitant use of propanolol
  * Tobacco use
  * Hepatotoxicity
  * Pregnancy

Primary outcomes:
measure: improvement in subjective and objective indicators of discomfort
timeFrame: 30 minutes
measure: improvement in subjective and objective indicators of discomfort
timeFrame: 30 minutes
Secondary outcomes:
measure: number of Adverse Events
timeFrame: 30 minutes
Other outcomes:
Locations:
city: Kansas City
country: United States
facility: Children's Mercy Hospital
state: Missouri
Study officials:
affiliation: Children's Mercy Hospital Kansas City
name: Rae A Kingsley, MSN, APRN
role: PRINCIPAL_INVESTIGATOR
References:
citation: Battaiglia, S. (2003). The complete guide to aromatherapy (2nd edition). Brisbane, Australia: The International Centre of Holistic Aromatherapy
citation: Blume HK. Pediatric headache: a review. Pediatr Rev. 2012 Dec;33(12):562-76. doi: 10.1542/pir.33-12-562. No abstract available.
citation: Buckle J. Use of aromatherapy as a complementary treatment for chronic pain. Altern Ther Health Med. 1999 Sep;5(5):42-51.
citation: Fitzgerald M, Culbert T, Finkelstein M, Green M, Liu M. The effect of gender and ethnicity on children's attitudes and preferences for essential oils: a follow up study. Explore (NY). 2010 May-Jun;6(3):172. doi: 10.1016/j.explore.2010.02.002. No abstract available.
citation: Gardiner P, Wornham W. Recent review of complementary and alternative medicine used by adolescents. Curr Opin Pediatr. 2000 Aug;12(4):298-302. doi: 10.1097/00008480-200008000-00002.
citation: Gaul C, Eismann R, Schmidt T, May A, Leinisch E, Wieser T, Evers S, Henkel K, Franz G, Zierz S. Use of complementary and alternative medicine in patients suffering from primary headache disorders. Cephalalgia. 2009 Oct;29(10):1069-78. doi: 10.1111/j.1468-2982.2009.01841.x. Epub 2009 Apr 2.
citation: Gobel H, Schmidt G, Soyka D. Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters. Cephalalgia. 1994 Jun;14(3):228-34; discussion 182. doi: 10.1046/j.1468-2982.1994.014003228.x.
citation: Halcon LL. Aromatherapy: therapeutic applications of plant essential oils. Minn Med. 2002 Nov;85(11):42-6.
citation: Kabbouche MA, Linder SL. Acute treatment of pediatric headache in the emergency department and inpatient settings. Pediatr Ann. 2005 Jun;34(6):466-71. doi: 10.3928/0090-4481-20050601-12.
citation: Keifer D, Ulbricht C, Abrams TR, Basch E, Giese N, Giles M, DeFranco Kirkwood C, Miranda M, Woods J. Peppermint (Mentha piperita): an evidence-based systematic review by the Natural Standard Research Collaboration. J Herb Pharmacother. 2007;7(2):91-143. doi: 10.1300/j157v07n02_07.
citation: Kligler B, Chaudhary S. Peppermint oil. Am Fam Physician. 2007 Apr 1;75(7):1027-30.
citation: Lee MS, Choi J, Posadzki P, Ernst E. Aromatherapy for health care: an overview of systematic reviews. Maturitas. 2012 Mar;71(3):257-60. doi: 10.1016/j.maturitas.2011.12.018. Epub 2012 Jan 27.
citation: Lewis D, Ashwal S, Hershey A, Hirtz D, Yonker M, Silberstein S; American Academy of Neurology Quality Standards Subcommittee; Practice Committee of the Child Neurology Society. Practice parameter: pharmacological treatment of migraine headache in children and adolescents [RETIRED]: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology. 2004 Dec 28;63(12):2215-24. doi: 10.1212/01.wnl.0000147332.41993.90.
citation: Loman DG. The use of complementary and alternative health care practices among children. J Pediatr Health Care. 2003 Mar-Apr;17(2):58-63. doi: 10.1067/mph.2003.29.
citation: Martin, I. (2007). Aromatherapy for Massage Practitioners. Lippincott Williams Wilkins; Baltimore, MD.
citation: Mauskop A. Alternative therapies in headache. Is there a role? Med Clin North Am. 2001 Jul;85(4):1077-84. doi: 10.1016/s0025-7125(05)70360-6.
citation: Mosby Skills Adapted from Perry, A.G., Potter, P.A., Ostendorf, W.R. (2014). Clinical nursing skills & techniques (8th ed.). St. Louis: Mosby
citation: Nishimura M, Tatsuya Saito TS, Kato T, Onodera S. Effects of Water Temperature during Foot Bath in Young Females. Yonago Acta Med. 2013 Sep;56(3):79-80. Epub 2013 Sep 11.
citation: Peterson CC, Palermo TM. Parental reinforcement of recurrent pain: the moderating impact of child depression and anxiety on functional disability. J Pediatr Psychol. 2004 Jul-Aug;29(5):331-41. doi: 10.1093/jpepsy/jsh037.
citation: Posadzki P, Alotaibi A, Ernst E. Adverse effects of aromatherapy: a systematic review of case reports and case series. Int J Risk Saf Med. 2012 Jan 1;24(3):147-61. doi: 10.3233/JRS-2012-0568.
citation: Roth-Isigkeit A, Thyen U, Stoven H, Schwarzenberger J, Schmucker P. Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics. 2005 Feb;115(2):e152-62. doi: 10.1542/peds.2004-0682.
citation: Saeki Y. The effect of foot-bath with or without the essential oil of lavender on the autonomic nervous system: a randomized trial. Complement Ther Med. 2000 Mar;8(1):2-7.
citation: Saeki Y, Nagai N, Hishinuma M. Effects of footbathing on autonomic nerve and immune function. Complement Ther Clin Pract. 2007 Aug;13(3):158-65. doi: 10.1016/j.ctcp.2006.12.006. Epub 2007 Feb 20.
citation: Schetzek S, Heinen F, Kruse S, Borggraefe I, Bonfert M, Gaul C, Gottschling S, Ebinger F. Headache in children: update on complementary treatments. Neuropediatrics. 2013 Feb;44(1):25-33. doi: 10.1055/s-0032-1333435. Epub 2013 Jan 11.
citation: Smith MC, Kyle L. Holistic foundations of aromatherapy for nursing. Holist Nurs Pract. 2008 Jan-Feb;22(1):3-9; quiz 10-1. doi: 10.1097/01.HNP.0000306321.03590.32.
citation: Stankewitz A, May A. Increased limbic and brainstem activity during migraine attacks following olfactory stimulation. Neurology. 2011 Aug 2;77(5):476-82. doi: 10.1212/WNL.0b013e318227e4a8. Epub 2011 Jul 20.
citation: Szema AM, Barnett T. Allergic reaction to mint leads to asthma. Allergy Rhinol (Providence). 2011 Jan;2(1):43-5. doi: 10.2500/ar.2011.2.0008.
citation: Termine C, Ginevra OF, D'Arrigo S, Rossi M, Lanzi G. Alternative therapies in the treatment of headache in childhood, adolescence and adulthood. Funct Neurol. 2005 Jan-Mar;20(1):9-14.
citation: Tisserand, R. & Balacs, T. (1995). Essential oil safety. Edinburgh: Churchill Livingstone
citation: Tisserand, R. & Young, R. (2014). Essential Oil Safety. A Guide for Health Care Professionals (2nd edition). Elsevier
citation: von Baeyer CL. Interpreting the high prevalence of pediatric chronic pain revealed in community surveys. Pain. 2011 Dec;152(12):2683-2684. doi: 10.1016/j.pain.2011.08.023. Epub 2011 Sep 14. No abstract available.