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A migraine patient's response to a medication taken for acute headache may be difficult to evaluate. An accurate assessment may be difficult to achieve when one is obtaining the headache history in a clinic, days to weeks after the attack(s) have occurred. Treatment response is subject to recall bias, and influencing that bias are expectations with regard to the achievement of pain-free status, degree of pain relief, time of onset of drug effect, recurrence of pain within a certain period of time, and side effects that are widely variable among patients. Cultural issues, gender, pain history, and numerous other variables also serve to further confound objective evaluation of a treatment's effects.

The headache attack report form we offer here is simple to complete and has been used successfully for nearly 15 years. In addition to providing “real time” assessment of a treatment's efficacy and tolerability, we believe it can serve as an instrument to improve compliance and perhaps foster a more productive therapeutic alliance between patients and caregivers.

Table 1. HEADACHE ATTACK REPORT Report Form to Be Completed Each Time a Headache Attack Is Treated. For Treatment, Please Follow Your Doctor's Instructions. Please Bring Your Forms With You to Your Clinic Appointment
Date:
Time of onset:
Drugs:………………………………………
…………………………………………………Headache*Nausea?Sensitivity to light?
  1. *Mild = headache present but does not interfere with routine activities; Moderate = headache not disabling but reduces ability to perform routine activities; Severe = disabling headache; cannot perform routine activities.

  2. **Only if you were headache-free after 4 hours.

  3. From Krymchantowski AV. Monitoring Patients' Response to Acute Migraine Treatment: A Headache Attack Report Form. Headache. 2006;46:346-348.

Time drug(s) taken() Mild() Yes() Yes
() Moderate() No() No
() Severe
 
After 1 hour() No headache() Yes() Yes
() Mild() No() No
() Moderate
() Severe
 
After 2 hours() No headache() Yes() Yes
() Mild() No() No
() Moderate
() Severe
 
After 4 hours() No headache() Yes() Yes
() Mild() No() No
() Moderate
() Severe
 
Did headache return before 24 hours?**() Yes 
() No
 
Was the headache present after 24 hours?() Yes 
() No
Report here all of the effects observed after taking the prescribed medication, including those not necessarily related:
 
 
Please write here the name of your doctor as well as your name