Correlation between novel checkmark-only headache diary and productivity loss and medication effectiveness in...

Migraine 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.

The 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.

After 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).

Our checkmark-only calendar diary systematically monitors productivity loss and treatment response in migraine patients, while maintaining patient adherence through its user-friendly design.