39 Practical experience with the use of electronic headache diaries 2 INTRODUCTION Telemedicine presents a hopeful prospect for improving the provision and customization of headache treatment. It has the potential to improve access to healthcare services especially for those who live in underserved areas, have mobility limitations, or face other barriers to in-person care. It can enhance cost-effectiveness of healthcare delivery by reducing travel time and expenses, minimizing waiting times, and optimizing healthcare resources. Patients diagnosed with headache such as migraine are excellent candidates for the use of telemedicine as monitoring of treatment may take place trough collection of diary data on headache frequency. In addition, Patient Reported Outcomes (PROMS) may be collected. Through this approach, medical professionals can remotely provide assistance to a patient, taking into consideration their lifestyle and medication regimen, while simultaneously ensuring adherence to prescribed medication(s) and monitoring its impact on the headache. In both clinical practice and research, there is often a need to quantify the frequency of migraine by determining the number of monthly migraine days (MMD), monthly headache days (MHD), and monthly acute medication days (MAMD). In an earlier study of our research group we clearly demonstrated a recall bias between self-reported and actual recorded MMD.1, 2 This emphasizes the necessity for a validated and easy-to-use daily headache diary in headache care. If an E-headache diary is not validated, there is a risk that the data collected may be unreliable, incomplete, or inaccurate, which could potentially lead to incorrect decision-making and ineffective treatment strategies. This could have negative consequences for patient health outcomes. The Leiden E-headache diary is time-locked and based on validated algorithms to determine whether a day is a (non-)headache day, a migraine day and/or an acute medication day.1, 3 Already in 2011 the Leiden Headache Center started web-based recruitment of participants with migraine using E-questionnaires.4 Nowadays, the Leiden Headache E-tools include validated screening- and extensive headache-, and comorbidity-questionnaires, and a daily E-headache diary, with the possibility to incorporate all E-tools in the same application that can be downloaded on a smartphone (Patient Journey app).1, 4 While various commercial headache diaries have entered the market, it is concerning that many lack a robust scientific foundation and expertise.5, 6 The onset of the COVID-19 pandemic highlighted the utility of these E-tools ensuring the continuation of migraine care.7 However, an exploration of their practical utility and acceptance in patient care remains unaddressed, which is an important aspect to evaluate when considering the incorporation of E-tools into routine patient care.
RkJQdWJsaXNoZXIy MjY0ODMw