Abstract text (incl. figure legends and references)

Background. Migraine is the leading cause of disability worldwide, affecting primarily working-age population. Poor availability of non-pharma cological treatment options and shortage of specialists is a major problem on a global scale. The goal of this pilot study was to create a model that would allow for comparisons between conventional and digitally mediated care while evaluating the cost-effectiveness of digitally mediated care.

Question. Is it possible to conduct manual-based digitally mediated non-pharmacological treatment in a way that is comparable to conventional treatment?

Methods. The pilot study was approved by the Research Ethics Committee of the University of Tartu. Two groups of patients (n=10 for conventional treatment and n=10 for digitally mediated treatment) participated in an intense 8-week non-pharmacological interdisciplinary treatment program. The patient received nurse counselling, cognitive-behavioural therapy, and physical therapy as part of their treatment. The number of headache days, headache's influence on everyday life, changes in quality of life, anxiety and depression levels were measured. The level of patient satisfaction with the intervention and the amount of work time required by experts were examined.

Results. There was no change in the number of days with headaches. In both groups, satisfaction with the intervention was extremely high. Indicators of quality of life improved in both groups. Ten times less time was spent on digitally mediated treatment by specialists.

Conclusions. The developed non-pharmacological intervention program and manual-based intervention are appropriate for a wider scale trial. Digitally mediated treatment is just as effective as conventional treatment but permits 10 times as many individuals to be treated without sacrificing quality. There is a need for larger-scale research to demonstrate with greater precision the influence on patients' lives and the cost-effectiveness of the intervention strategy.