Use of a structured migraine diary improves patient and physician communication about migraine disability and treatment outcomes

Abstract

Migraine is frequently undertreated, perhaps because impaired communication between patients and physicians underestimate the disability associated with migraine attacks. The purpose of this study was to evaluate the benefits of a structured migraine diary used during a prospective open-label study of triptan-naive patients in Spain for recording information on response to therapy for a pre-study migraine attack and three consecutive migraine attacks, the first and third treated with rizatriptan 10-mg wafer and the second with usual non-triptan therapy. Of 97 patients (83% women; mean age, 39 years) who completed the study, all reported moderate to severe pain, and two-thirds reported severe to total impairment during migraine attacks. At study end, 72% of patients reported that the migraine diary helped communication with their doctor about migraine, and 70% were more or much more satisfied than before the study with level of overall medical care provided by their doctor. Patients who reported the diary to be useful also reported higher overall satisfaction with medical care (p < 0.001). Most of the 22 physicians (91%) reported that the diary enabled them to better communicate with their patients about migraine, and all reported that it enabled them to assess differences in pain intensity and disability across patients. We conclude that a structured migraine diary can be a valuable aid for improving communication between physicians and patients regarding migraine disability and treatment outcomes.

Psychological Approaches to Headache

“…The first is through standardizing methods of gaining information regarding headache. Utilization of surveys about headache symptoms and quality of life (such as the Migraine Disability Assessment or MIDAS), 123 and standard headache diaries, 124 can provide a starting point for conversations about migraine symptoms and improve communication about migraine. 124,125 The second method is through improving communication techniques to enhance understanding between the physician and patient.…”

“…Utilization of surveys about headache symptoms and quality of life (such as the Migraine Disability Assessment or MIDAS), 123 and standard headache diaries, 124 can provide a starting point for conversations about migraine symptoms and improve communication about migraine. 124,125 The second method is through improving communication techniques to enhance understanding between the physician and patient. 126 One useful technique is the "askÀtellÀask" method of communication, which involves asking an open-ended question, relaying in simple terms information pertinent to the patient's treatment, and then, to ensure understanding, requesting that the patient rephrase what was just communicated.…”

“It’s Not Just Technology, It’s People”: Constructing a Conceptual Model of Shared Health Informatics for Tracking in Chronic Illness Management (Preprint)

“…Tracking can be an effective part of managing chronic illness, improving health outcomes [18] as well as communication with healthcare providers [19]. The Pew Internet & American Life Project [10] recently reported that 69% of Americans track health data for themselves or a loved one.…”

Supporting chronic disease care quality

“…Pain diaries help patients to better assess their pain [de Wit et al 1999] and even reduce it [Cruise et al 1996]. They also improve communication between physicians and patients [Baos et al 2005]. Non-compliance with medical regimens prescribed by physicians is a major problem in chronic disease care [Cochrane et al 1999;Vermeire et al 2001] and patient diaries were shown to improve it [van Berge Henegouwen et al 1999].…”