Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Correlation between novel checkmark-only headache diary and productivity loss and medication effectiveness in migraine patients.
Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMigraine reduces life quality and work productivity through absenteeism and presenteeism. However, existing paper-based headache diaries have limitations (time-consuming interpretation of heterogeneous entries, inadequate capture of work-related outcomes, etc.). We developed a calendar-style diary with checkmark-only entries to address these shortcomings, while maintaining simplicity for sustained patient adherence. In this single-center retrospective observational study, we assessed whether this format captures important information on patients with migraines attending a specialized headache clinic.
methodsThe diary features five key elements: disability quantification (five levels: full-day absence to no productivity loss), headache occurrence time, headache intensity (severe vs. mild to moderate), acute medication intake with an effectiveness assessment, and migraine triggers. Simple diary-derived scores were created to assess absenteeism, presenteeism, headache intensity, and medication effectiveness. Correlation analyses were performed between these scores and validated questionnaires: Work Productivity and Activity Impairment (WPAI) and Migraine Assessment of Current Therapy (Migraine-ACT) for 7- and 31-d datasets, respectively.
resultsAfter applying exclusion criteria, 222 and 188 participants were included in the 7- and 31-d datasets, respectively. Diary scores showed meaningful correlations with WPAI domains: absenteeism score with work absenteeism (Kendall's τ = 0.35), presenteeism score with presenteeism (Spearman's ρ = 0.41), overall work impairment (ρ = 0.41), and activity impairment (ρ = 0.36). The number of ineffective medications negatively correlated with the Migraine-ACT score (ρ = -0.27).
conclusionsOur checkmark-only calendar diary systematically monitors productivity loss and treatment response in migraine patients, while maintaining patient adherence through its user-friendly design.
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