Headache Diary Mobile Application for Monitoring and Characterizing Posttraumatic Headaches
Kevin Liu1, Esmeralda Madrigal, Joyce S Chung
1Polytrauma Network Site and Headache Center of Excellence (Ms Madrigal and Dr Timmerman), Polytrauma System of Care and Rehabilitation Services (Dr Chung), Polytrauma Network Site (Dr Broffman), and Rehabilitation Service (Dr Adamson), VA Palo Alto Health Care System, Palo Alto, California (Mr Liu, Dr Harris, and Mss Bennett and Tsai); Palo Alto University, Palo Alto, California (Mr Liu); University of Washington, Seattle (Ms Bennett); University of California Santa Barbara (Ms Tsai); and Department of Neurosurgery (Dr Harris) and Orthopaedic Surgery & Physical Medicine & Rehabilitation (Dr Timmerman), Stanford University School of Medicine, Stanford, California (Dr Adamson).
Objective:
This study analyzed the data collected using a headache diary mobile application to characterize posttraumatic headaches (PTHs) in a sample of US veterans. Specifically, we measured patient engagement with the mobile application and compared our findings with previous literature regarding PTHs.
Setting:
A Headache Center of Excellence (HCoE) in a Veterans Health Administration facility.
Participants:
Forty-nine veterans currently being treated for ongoing PTH-related complaints with English fluency, reliable access to the internet, and a mobile phone.
Design:
Observational study of PTH characteristics using the mobile application over the course of 1 year.
Measures:
Main outcome measures were collected via a headache diary mobile application developed for patients to track headache-associated symptoms, headache location, triggers, type, intensity, and duration. Patients also completed a baseline Headache Impact Test (HIT-6) survey.
Results:
In total, 1569 entries were completed during the first year of application deployment. On average, patients completed 2.5 entries per week and used the application for 70 days. They frequently reported associated PTH symptoms of photophobia (56.7%) and headaches triggered by emotional stress (35.1%). Network analyses revealed patterns of co-occurrence in triggers of headache pain, associated symptoms, and headache pain location. Headache pain severity and impact ratings from the headache diary demonstrated convergent validity with the established HIT-6 measure.
Conclusions:
Headache diary mobile applications are a promising tool for monitoring and characterizing PTHs in veterans. Present results mirror past studies of PTH characteristics. Mobile application headache diaries may be used in both clinical and research settings to monitor headache symptoms and communicate the functional impact of headaches in real time.
