Reasons for Non-Compliance to the Headache Diary Report among Migraine Patients in a Tertiary Health Facility: A Qualitative Study

Abstract

Background: There are limited number of qualitative studies on headache and headache log-book for headache management. This paper aimed to describe the perception towards headache and the headache log-book and to explore reasons for non-compliance on regularity recording information.

Methods: The qualitative study was conducted among migraine patients at the out patient department of the tertiary health facility in Bangkok.  Twenty-one migraine patients 20 years of age or older were purposively selected for in-depth interviews.  Qualitative guide was developed that includes questions related to perception towards migraine headache and the headache log-book, the reasons for non-compliance on paper based headache diaries recording.  Content analysis was used for qualitative data analysis. This study was ethically approved from  institutional review board of Faculty of Medicine, Chulalongkorn University Thailand.

Results: Perception towards migraine headache was different and varied among time and situation during the attack. The participants described this condition as the suffering, annoyed, almost dead and fear. Perception among patients on headache log-book grouped in five items; confused, useful, unnecessary /no time to record, similar to homework and over burden. The benefits of headache log-book were useful for patients and physicians for headache treatment.  The reasons for not recording the headache log-book were unnecessary, forgetfulness, limited knowledge on recording, no time, unable to remember and lazy/ bored.  Ways to remind the recording were include; going back and forth of the headache log-book , writing it down first on papers, record in diary and kept the log-book beside the medicines. The participants stated that they did not know how to start the recording, small spaces for recording and the text is too small to read were the major obstacle. Patients were of suggestions for re-designing the log-book, take a short note, using card/calendar for the recording, check the log-book daily.

Conclusions: The findings allow us to gain understanding how patients described their illness and the reasons for non-compliance on the headache log-book recording. Patient’s motivation should be taken into account for benefit of migraine headache management.