Why Patients Do Not Comply With Headache Diaries?

Background: /ObjectiveHeadache calendars are part of good clinical practice in headache clinics. However, patients’ compliance is rather variable. We aim to identify factors associated with poor compliance.MethodsConsecutive patients observed in follow-up visits of a tertiary headache center were divided into two groups; with a fullfilled calendar (Calendar compliers, CC) and without calendar (Calendar noncompliers, CNC). Incomplete /forgotten records were excluded. Demographic and clinical variables were compared, and CNC were asked the reasons for not filling the calendar. ResultsFrom 93 patients (45.6±13.3 years, on average; 83 females), the majority with migraine (96.8%), 61.3% were CC. CNC were more likely to have medication overuse (34.5% vs. 12.3%, p=0.01) and had a tendency to be paid workers (79.3% vs. 52.6%, p=0.05) compared to CC.Most CC considered calendars useful to improve doctors and patients knowledge about headaches.ConclusionsAlthough these results need to be evaluated in other contexts, they suggest that patients with medication overuse have a more denial attitute towards headache records and may need additional reinforcement.