Young Nathan P, Stern Jennifer I, Steel Stephanie J, Ebbert Jon O
Department of Neurology, Mayo Clinic, 200 First St. SW Eighth Floor, Rochester, MN, 55905, United States, 1 5072842844.
Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.
JMIR Form Res. 2025 Mar 26;9:e66763. doi: 10.2196/66763.
We implemented a novel mobile app-based Migraine Interactive Care Plan (MICP) integrated with our electronic health records (EHRs). The MICP facilitates remote assessment of adult patients with migraine, educational content delivery, and care team communication. Feasibility of the MICP was demonstrated in a pilot implementation study.
We aimed to assess the preferences and satisfaction of patients with migraine users of a mobile app-based care plan integrated with the EHR.
An electronic survey was administered to a single cohort of MICP users between December 6, 2021, and December 30, 2021. The survey assessed patient preferences for which data to track, frequency of tracking, and satisfaction with the MICP. Survey responses were compared between subsets determined by patient-reported headache frequency and treatment with and without botulinum toxin and calcitonin gene-related peptide (CGRP) antagonist therapy. The Wilcoxon rank-sum test was used for continuous variables and the χ2 test or Fisher exact test for categorical variables.
The total sample size was 184 and the survey response rate was 30.4% (56/184). No significant differences in age (P=.26) or sex (P=.19) between respondents and nonrespondents were observed. Respondent median age was 42 (range 20-72) years and 94.6% (53/56) were female. Headache frequency was (1) 0 to 8 days (26/56, 46.4%), (2) 9 to 14 days (12/56, 21.4%), and (3) 15 or more days (18/56, 32.1%). No difference was observed in any survey responses based on headache frequency or treatment. The majority of respondents preferred to track headache days weekly (30/56, 53.6%) or daily (15/56, 26.8%) and preferred to change the frequency of headache tracking reminders (42/56, 75%). Respondents were somewhat or very interested in daily tracking personal observations in free text (41/52, 78.8%), medication treatment (43/52, 82.7%) and treatment response (39/56, 69.6%), class of medication treatment (36/52, 69.2%), severity of functional impairment (39/56, 69.6%), type of functional impairment (35/53, 66%), headache day (40/54, 74.1%), and headache pain level on a scale of 1 to 10 (38/53, 71.7%). Respondents agreed or strongly agreed that the education content was useful (31/51, 60.8%) but lacked personalization (25/51, 49%). Most respondents agreed or strongly agreed that they were satisfied with the MICP (38/50, 76%) and that it helped them communicate with their care team (38/53, 71.7%).
Most MICP users were motivated to track headache frequency, medication treatment with response, functional impairment, and pain intensity. Opportunities to improve the MICP include (1) allowing patients to change the frequency of assessments and notifications; (2) recording personal observations or comments through free text, which may include headache triggers; (3) assessment of headache severity using a 1 to 10 pain scale; and (4) tailoring headache education based on frequency and severity (episodic vs chronic migraine). These observations may be useful to improve the usability of the MICP and similar EHR-integrated migraine care platforms that others may develop.
我们实施了一种基于移动应用程序的新型偏头痛交互式护理计划（MICP），该计划与我们的电子健康记录（EHR）集成。MICP有助于对成年偏头痛患者进行远程评估、提供教育内容以及护理团队沟通。在一项试点实施研究中证明了MICP的可行性。
我们旨在评估使用与EHR集成的基于移动应用程序护理计划的偏头痛患者的偏好和满意度。
在2021年12月6日至2021年12月30日期间，对一组MICP用户进行了电子调查。该调查评估了患者对跟踪哪些数据、跟踪频率以及对MICP的满意度的偏好。根据患者报告的头痛频率以及是否接受肉毒杆菌毒素和降钙素基因相关肽（CGRP）拮抗剂治疗，对调查结果在不同亚组之间进行了比较。对于连续变量使用Wilcoxon秩和检验，对于分类变量使用χ2检验或Fisher精确检验。
总样本量为184，调查回复率为30.4%（56/184）。未观察到回复者与未回复者在年龄（P = 0.26）或性别（P = 0.19）上有显著差异。回复者的年龄中位数为42岁（范围20 - 72岁），94.6%（53/56）为女性。头痛频率为：（1）0至8天（26/56，46.4%），（2）9至14天（12/56，21.4%），以及（3）15天或更多天（18/56，32.1%）。基于头痛频率或治疗情况，在任何调查结果中均未观察到差异。大多数回复者更喜欢每周（30/56，53.6%）或每天（15/56，26.8%）跟踪头痛天数，并更喜欢更改头痛跟踪提醒的频率（42/56，75%）。回复者对以自由文本形式每日跟踪个人观察情况（41/52，78.8%）、药物治疗（43/52，82.7%）和治疗反应（39/56，69.6%）、药物治疗类别（36/52，69.2%）、功能损害严重程度（39/56，69.6%）、功能损害类型（35/53，66%）、头痛日（40/54，74.1%）以及1至10级头痛疼痛程度（38/53，71.7%）有些或非常感兴趣。回复者同意或强烈同意教育内容有用（31/51，60.8%）但缺乏个性化（25/51，49%）。大多数回复者同意或强烈同意他们对MICP满意（38/50，76%），并且它帮助他们与护理团队沟通（38/53，71.7%）。
大多数MICP用户有动力跟踪头痛频率、药物治疗及其反应、功能损害和疼痛强度。改进MICP的机会包括：（1）允许患者更改评估和通知的频率；（2）通过自由文本记录个人观察或评论，这可能包括头痛触发因素；（3）使用1至10的疼痛量表评估头痛严重程度；以及（4）根据频率和严重程度（发作性偏头痛与慢性偏头痛）定制头痛教育。这些观察结果可能有助于提高MICP以及其他人可能开发的类似EHR集成偏头痛护理平台的可用性。
