Which Factors Affect Daily Compliance With an Internet Headache Diary Among Youth With Migraine?

Abstract

Objective: To determine the specific factors that affect Internet headache diary compliance among youth with primary headaches.

Materials and methods: Patients aged 10 to 18 years completed a 90-day Internet-based headache diary with date-stamping and time-stamping features that allowed compliance monitoring. Eight potential predictors were assessed in a multilevel statistical model of headache diary compliance: age, sex, diary entries during the school year versus summer, entries on evenings preceding weekends (Friday or Saturday) versus evenings preceding weekdays (Sunday through Thursday), headache days versus nonheadache days, headache intensity ratings, use of an abortive headache medicine, and the first 2 weeks of diary use versus the latter 76 days.

Results: Fifty-two patients generated 4680 diary entries; 3215 (68.7%) entries were compliant (completed via same-day diary entries). Compliance for each diary participant ranged from 39% to 97% (mean, 68.7%; median, 70%; SD=0.15%). Three specific factors were associated with diary compliance in the multilevel model. Compliance was better on days when an abortive headache medicine was used (P<0.001; odds ratio [OR], 33.7 [95% confidence interval [CI], 13.1-86.6]) and during the first 2 weeks of the diary period versus the remaining 76 days (P=0.05; OR, 1.3 [95% CI, 1.03-1.68]). Compliance was worse on evenings proceeding weekends versus evenings preceding weekdays (P<0.001; OR, 0.55 [95% CI, 0.46-0.66]). Patients who did not start the diary protocol (n=12) or did not complete the 90 days (n=14) were excluded from the analysis.

Discussion: Specific factors predict Internet-based headache diary compliance. Further research about the factors related to diary compliance and the optimization of diary-based data collection is warranted.