An electronic diary on a palm device for headache monitoring: a preliminary experience

Abstract

Patients suffering from headache are usually asked to use charts to allow monitoring of their disease. These diaries, providing they are regularly filled in, become crucial in the diagnosis and management of headache disorders because they provide further information on attack frequency and temporal pattern, drug intake, trigger factors, and short-/long-term responses to treatment. Electronic tools could facilitate diary monitoring and thus the management of headaches. Medication overuse headache (MOH) is a chronic and disabling condition that can be treated by withdrawing the overused drug(s) and adopting specific approaches that focus on the development of a close doctor–patient relationship in the post-withdrawal phase. Although the headache diary is, in this context, an essential tool for the constant, reliable monitoring of these patients to prevent relapses, very little is known about the applicability of electronic diaries in MOH patients. The purpose of this study was to evaluate the acceptability of and patient compliance with an electronic headache diary (palm device) as compared with a traditional diary chart in a group of headache inpatients with MOH. A palm diary device, developed in accordance with the ICHD-II criteria, was given to 85 MOH inpatients during the detoxification phase. On the first day of hospitalization, the patients were instructed in the use of the diary and were then required to fill it in daily for the following 7 days. Data on the patients’ opinions on the electronic diary and the instructions given, its screen and layout, as well as its convenience and ease of use, in comparison with the traditional paper version, were collected using a numerical rating scale. A total of 504 days with headache were recorded in both the electronic and the traditional headache diaries simultaneously. The level of patient compliance was good. The patients appreciated the electronic headache diary, deeming it easy to understand and to use (fill in); most of the patients rated the palm device handier than the traditional paper version.

Electronic‐Diary for Recording Headaches, Triggers, and Medication Use: Development and Evaluation

“…Acceptability ratings found here are consistent with previous studies, which have reported high participant acceptability ratings of headache diaries . Similar to this study, Allena et al found that e‐diaries were rated as easier to use than paper‐based diaries . Previous research has relied on a handful of non‐theory‐based questions in assessment of participant acceptability of electronic and paper‐based headache measures, and hence there are no comparisons studies available for the current findings on differential group reports on compatibility and intention to use.…”

Treatment Adherence in Patients With Headache: A Systematic Review

“…The extant literature includes nine studies examining patient adherence to a variety of headache diaries, such as paper and pencil diaries, electronic diaries, and online digital assistant (ODA) self‐monitoring. Documented adherence rates to paper headache diaries for patients with headache and migraine are 83.3% and 95%, while adherence rates to electronic headache diaries are 90% in patients with migraine and 98% in patients receiving inpatient treatment for medication overuse headache . Allena and colleagues also investigated the relationship between demographic and disease variables with electronic headache diary adherence and found differences in diary adherence based on age, education, or baseline headache disability .…”

“…Documented adherence rates to paper headache diaries for patients with headache and migraine are 83.3% and 95%, while adherence rates to electronic headache diaries are 90% in patients with migraine and 98% in patients receiving inpatient treatment for medication overuse headache . Allena and colleagues also investigated the relationship between demographic and disease variables with electronic headache diary adherence and found differences in diary adherence based on age, education, or baseline headache disability . Tassorelli and colleagues provided data for varying levels of diary completion which demonstrated that 71% of patients with headache and migraine returned a “completed” diary, 28% returned an “almost” completed diary, and 1% returned a “fairly” completed diary .…”

Opinion & Special Articles: Professionalism in neurology

“…More than half of this burden in disability-adjusted life years (DALYs) is contributed by cerebrovascular disease, Alzheimer and other dementias, epilepsy, and migraines. EMR have been shown to be useful in the management of these diseases 4,5 as they promote better coordination within the health care system.…”