Digital diary app use for migraine in primary care: prospective cohort study

Background: Headache diaries are recommended for migraine management in primary care. Objective: Determine the acceptability and use of a digital headache diary app for migraine. Methods: Evaluative prospective primary care cohort study in North of England. Part 1 was a postal survey; if responders were interested, in Part 2 participants trialled the digital N1-Headache App headache diary for 90 days, followed by survey feedback on the App’s usability. Results: A total of 637 out of 2189 invited patients (29%) completed the initial survey, and 32% of respondents had previously used a headache diary; 437 out of 637 patients (69%) were interested in using the App. Regression analysis showed that interested patients were those with more severe migraines that limit physical/intellectual activities, and who indicate to not know enough about their migraine. Actual registration numbers and compliance with the App was very modest; 53 out of 173 participants (23%), who ultimately activated their personal N1-Headache App account, were able to generate a personalised trigger and protector map & report. Furthermore, at the end of the 90 day app trial period there was a non-significant trend towards improvements in participants’ health confidence levels. Conclusion: Migraine patients – particularly those with more severe and frequent migraines - show an interest in using a digital headache diary app, ultimately, consistent daily use is very modest. The challenge is to improve app usage and compliance rates to allow interpretation of more patients’ migraine trigger and/or protector patterns, and wider use amongst patients.