What are Headache Smartphone Application (App) Users Actually Looking for in Apps: a Qualitative Analysis of App Reviews to Determine a Patient Centered Approach to Headache Smartphone Apps

Abstract

Background:

Many headache smartphone applications (apps) are commercially available. A Modified Delphi Study aimed to determine specialists’ expectations of what a headache app should entail but consumer expectations of headache apps have not been evaluated extensively.

Objective:

To evaluate publicly available reviews of headache apps to understand app features that motivate consumers to use apps.

Methods:

The Google Play and Apple App Stores were systematically searched for headache/migraine diary apps with 10+ consumer reviews. A maximum of 300 “Most Helpful” reviews for each app were extracted. Four coders coded reviews and resolved discrepancies. Themes and sub-themes were created based on codes used 5+ times.

Results:

15 apps met study criteria (9 Android, 6 IOS). 945 reviews were coded. Four themes emerged: (1) App allows users to track headache characteristics, potential triggers, and treatments; (2) App usability; (3) Personalization and features to assess trends in data are key motivators for app use; (4) Ease with exportation and viewing data is critical.

Discussion:

A user-centered design with the ability to (1) customize key features including headache characteristics, potential triggers and treatments, (2) assess trends in data and (3) view and export data would best optimize headache smartphone applications based on consumer preference.

Introduction

A mainstay of migraine management is tracking headaches and headache-related symptoms in a diary.^1,2 This not only helps patients to better understand the nature of their headaches and related symptoms, but also assists healthcare providers in adequately diagnosing and treating patients’ headaches.¹

Few studies have examined commercially available smartphone-based headache applications. A systematic review of commercially available apps in 2013 examined specific features of headache apps such as price, technical requirements, language, assessment schemes, types of reports (plain text, table, graphs/charts), ability to edit previous headache entries, ability to export data from the app (eg, email, PDF), and more.² The authors compared these features to seven app criteria which were “created with headache expertise, formal psychometric and feasibility testing, clinically relevant headache variables measured, usable, customizable answer options and reports, reports linking multiple variables, and export headache data from app.” Of the 38 apps assessed in the systematic review, only 18% of the apps were created with scientific or clinical headache expertise, and none met all 7 app criteria. Few studies have examined user involvement in headache app usage.

There is little research examining user involvement in headache app usage. One qualitative study consisting of two iterative cycles of three focus groups with a total of 25 participants (six male and 19 female) revealed five themes³(Table 1). The second qualitative study, conducted by our study team, was based on four focus groups of patients with migraine who had participated as research subjects in headache app-based research studies.⁴ It also resulted in five themes (Table 1).

Table 1:

Themes that Emerged in Prior Qualitative Studies

Themes from “Bringing psychosocial support to headache sufferers using information and communication technology: Lessons learned from asking potential users what they want” by Huguet A, Stinson J, Mackay B, et al.3

Themes from “Focus group findings on the migraine patient experience during research studies and ideas for future investigations” by Minen M, Morio K, Schaubhut K, Powers S, Lipton R, Seng E.4

Headache experience-“the participant’s experience with headaches including headache characteristics, level of interference, triggers, and management.” Diary-“features of the diary that participants found appealing, including methods of diary entry, things participants believed the diary should capture and diary characteristics (personalization, interactivity, etc).” Treatment-“participants described the aspects of the treatment they desired: general headache information, management strategies, medication information, and social support. Multidevice delivery-“program delivery over both iPhone and PC was ideal as long as the two devices were synchronized.” Recruitment-“methods participants believed were best to use to recruit future participants.”

“Completing diaries on a daily basis is challenging”; “Technical difficulties and uncertainties about app features limit use”; “Increased opportunity to interact with other people with migraine would be beneficial”; “Navigating the app and data entry should be easier”; “More varied methods for viewing the data and measures of adherence are needed.”

From a physician’s perspective, it has been suggested that a detailed app that tracks triggers, symptoms, and other headache information will satisfy a patient’s goal to understand his or her headaches better. Where understanding headache is the primary goal of the patient, doctors are primarily focused on the “3F’s”: Frequency of days with headache, frequency of acute medication usage, and functional impairment.¹

Still, there is little data on what users value in current commercially available headache apps. Incorporating user feedback is important for user engagement.^3,5,6 Thus, we sought to conduct a qualitative analysis of consumer reviews to determine users’ wants and expectations in a headache app.

Methods

As this research study did not involve interaction or intervention with human subjects and did not use identifiable data, no institutional review board (IRB) approval was required.

App Selection:

A priori, a decision was made to select up to 20 headache/migraine apps from the Apple App Store and up to 20 headache/migraine apps from Google Play Store that met the pre-specified inclusion criteria (Table 2). Apps that did not meet the inclusion criteria in Table 2 were not included. In July 2019, SA and KT screened the Apple App Store and Google Play Store to search for the apps. The terms “migraine” and “headache” were inputted in the search-bar of each app store.

Table 2.

Criteria for App Selection

1	App is available in English
2	App is targeted for people who want to monitor their headaches
3	App has stand-alone functionality, meaning it is usable without a membership, subscription or ownership of certain devices
4	App has at least 1,000 downloads (for Android only as Apple does not publish the number of downloads)
5	App has at least 10 reviews

Data Collection:

Following the determination of the qualifying apps, their user reviewers, as filtered by “Most Helpful,” were extracted into an excel sheet. Given that the app store allows users to designate customer reviews as either “Helpful” or “Not Helpful,” filtering by “Most Helpful” produces the reviews that received the greatest number of “Helpful” ratings for a given app. The Android app reviews were extracted directly from the Google Play Store website. An Application Programming Interface (API) through iTunes was used to extract the most helpful reviews for the IOS apps selected in JSON format for easy extraction. A priori the decision was made to extract up to 300 reviews for each individual app, though if an app appeared in both the Google and Apple Stores, 150 reviews of the app were taken from each app store (for a total of 300 reviews).

Data Coding Procedure:

(1) Four coders each read and blindly coded 150 unique app reviews, extracting keywords, phrases, and themes. (2) A code book was then created by analyzing all of the codes created, eliminating redundancies between them, and placing them into categories. (3) The app reviews were then split into four equal sections for each coder, each coder independently coding two sections solely using codes in the code book. (4) After each section was independently coded by two coders, coders who coded the same sections viewed each other’s codes and resolved discrepancies between them. Examples of such discrepancies involve one coder including a code that the other did not, or one coder believing that the other coder included a code that should not be there. After each round of discrepancies, the four coders came together to discuss common discrepancies and ways to resolve them. If both coders failed to come to an agreement, it was agreed that a third party would settle the dispute, but this was never needed. (5) After all discrepancies were resolved, codes were counted and categorized. Together, all four coders discussed and agreed upon themes and subthemes based upon the codes that appeared most frequently.

Results

A total of 15 apps met our selection criteria (6 IOS apps, 9 Android) (Table 3) with resulting 945 consumer reviews extracted for this qualitative analysis (Table 4). There were 355 codes developed based on all of the consumer reviews. The mean number of codes per app was 5±3 [1–18]. Table 4 shows the four main themes and their sub-themes, with the corresponding codes for each subtheme. The four main themes that emerged were as follows: (1) App allows users to track headache characteristics, potential triggers, and treatments. (2) App usability. (3) Personalization and features to assess trends in data are key motivators for app use. (4) Ease with exportation and viewing data is critical.

Table 3:

The 15 apps and the number of reviews per app that were looked over in the study, divided by Android and IOS.

Type of Application	Reviews
Android
Headache Log	221
Migraine Buddy	153
Migraine Insight	63
Migraine Monitor	62
Migraine Headache Diary HeadApp	60
My Cluster Headache	26
Headache Diary Free	20
Headache Tracker and Treatment	19
iMigraine	9
IOS
Migraine Buddy	149
Migraine Insight	71
Ease: Headache and Migraine	32
N1 Headache	27
iMigraine	17
Migraine Monitor	16

Table 4:

The 4 main themes with 13 sub-themes and the corresponding codes related to each subtheme (including the number of times a code appeared).

(1) USERS WANT THE ABILITY TO TRACK HEADACHE CHARACTERISTICS, POTENTIAL TRIGGERS, AND TREATMENTS
(1.1) Track triggers		(1.2) Track treatments		(1.3) Track headache information
track ha triggers	109	track ha symptoms	61	track ha	284
track weather/pressure changes	29	track medications	57	track ha duration	37
track pain	21	track sleep	38	track ha intensity	30
track diet/water	9	track effective treatments	27	track ha frequency	29
real-time tracking	9	track progress	9	track ha location	25
		track treatment plan	8	record migraine attack data	16
		track health	8	track ha patterns	15
		track med effectiveness	7	track migraine	9
		track treatments	5	record headache description	6
(1.4) Users suggest features to log relevant information
suggestion: track intensity over time	21	suggestion: connect to activity tracker	8	suggestion: easier data entry	6
suggestion: record food intake	12	suggestion: add more options for symptoms	7	suggestion: ability to edit medications	6
suggestion: track time of day that medication was taken	10	suggest treatments	7	suggestion: dark mode	5
suggestion: track headache start time and end time rather than duration	8	suggestion: modify graphs	6	suggestion: add daily notes	5
suggestion: input headaches that last over the end of the day	8	suggestion: improve medication page	6	issue: cannot enter multi day ha	5

(2) APP USABILITY IS ESSENTIAL
(2.1) Apps allow viewing/editing of existing records		(2.2) Design features for migraine sufferers are appreciated		(2.3) Developer services satisfy customers
personalization	76	app is easy to use	228	appreciates developers	169
app is well designed/good visuals	54	app is helpful	226	constant improvements	23
record data later	21	daily use	12	fast/good customer service	15
change/delete info	13	suggestion: better layout	11	developers need to make improvements with app	11
good interface	7	reminder to input info	9
issue: editing triggers	5	app is fast	6
		previously lost track of records	5
		issue: interface problems	5
		app takes time to learn	5
(2.4) Technical difficulties limit app usage
glitches/crashes	25	too many notifications/reminders	8	preferred app before update	7
issue: changing inputs	22	issue: trouble logging headache information	8	issues with time entry	7
suggestion: allow users to edit/delete existing record	16	issue: lost data	8	issue: medications	7
app is hard to use	14	issue: input deleted	8	issue: can’t predict when ha will end	7
unpaid version is inferior	13	issue: cannot register	8	cannot export/print data	7
app is overwhelming	12	general app issues	8	app asks too many questions	6

(3) PERSONALIZATION AND FEATURES TO ASSESS TRENDS IN DATA ARE KEY MOTIVATORS FOR APP USE
(3.1) Apps point out trends in data		(3.2) Customization by collection of user’s personal information
identify potential triggers	117	migraine	330	frequent headaches	9
app is insightful/informative	75	app is detailed	96	tension headaches	9
identify patterns	55	personalization	76	user is forgetful	7
identify effective treatments	31	make notes	40	daily headaches	7
app validates ha	16	chronic migraines	24	migraine free	7
recognize potential ha attack	5	cluster headaches	18	daily migraines	5
		headache	17
(3.3) App provides relief
app provides relief	47	app validates ha	16	migraine free	7
app gives sense of community	35	app contains exercises to help with headaches	10	experiencing lower intensity ha	7
experiencing fewer headaches	24	includes a preventative relaxation technique	8	prompts and questions	6
app gives them control of ha	21	helps user avoid triggers	8	cannot relieve ha	5

(4) EASE WITH EXPORTATION AND VIEWING OF DATA IS CRITICAL
(4.1) App generates data reports		(4.2) App assists doctors in better treating user’s headaches
app is detailed	96	show to doctor	186	doctor likes app	9
app is superior to others	94	doctor can give appropriate treatments	23	app is helpful to doctor	7
data reports/summary	85	doctor recommends	16
export/print data	30
easier than spreadsheet/paper diary	20
create graphs/tables	18

Theme 1: App allows users to track headache characteristics, potential triggers, and treatments.

A majority of user reviews included comments regarding an app’s potential to be used as a headache tracker. The reviews often emphasized the app’s ability to track treatments, triggers, and headache information.

Subtheme (1.1): track triggers

Many user reviews noted the app’s ability to track a variety of headache triggers. Users liked to track pain, diet (i.e different foods, calorie counts, or water intake), and pressure/weather changes (i.e. cloudy, rainy, sunny, snowy weather) that could affect their headaches. Users often mentioned a decrease in the frequency of their headaches because the app helped them understand the potential triggers causing their headache. They also frequently mentioned that the app assisted them in avoiding these triggers, which helped to relieve their headaches.

Subtheme (1.2): Track Treatments:

Many users commented on the app’s ability/inability to track medications or treatments for their headaches. They also commented on its ability to track sleep, headache symptoms, and other health metrics that are affected by treatment progress.

Subtheme (1.3) track headache information:

Consumer reviews mentioned the app’s ability to record and track relevant headache information, such as headache duration, intensity, frequency, and location. This allowed users to visualize patterns in their headaches.

Subtheme (1.4) users suggest features to log relevant information:

Apps that lacked the ability to track headache information contained reviews that included suggestions for developers to include more features in the apps for logging headaches. For example, a majority of reviewers suggested that an app should “track headache intensity over time” or “input headaches that last over a day.” For some apps, user suggestions indicated a need for a more detailed and intuitive headache tracker and features that would make logging a headache in real time easier with a dark mode for light sensitive headache patients.

Theme 2: Apps Usability

Reviews indicate that the app should contain a user-centered design such as features tailored to migraine patients that make the app easy and fast to use.

Subtheme (2.1): Apps allow viewing/editing of existing records

Several users appreciate personalization of the app, such as easy customizable features that record important details about headaches even after the headache is over. Users also enjoy recording information such as symptoms/treatments that are not traditionally listed in the app.

Subtheme (2.2): design features for migraine sufferers are appreciated

A majority of the positive reviews praised features targeted to headache patients for being easy to use, helpful, or quick to learn. On the other hand, user reviews indicate that a better layout for ease in viewing previous information or data is needed. Additionally, headache patients value the app’s features that send reminders to input information about their headaches.

Subtheme (2.3): technical difficulties limit app usage

Some negative user reviews indicate issues within apps such as glitching or crashing, losing data records, or not being able to edit previous headache logs. Also, some design features are noted as being overwhelming as they make it difficult for users to record their acute headache attacks. Losing recorded information can be burdensome for headache patients, and visualization of data is key to understanding their headaches.

Subtheme (2.4): developer services satisfy customers.

A large number of reviews expressed appreciation for the developers of the app and their willingness to make constant improvements based on consumer feedback.

Theme 3: Personalization and features to assess trends in data are key motivators for app use

A majority of the reviews praised apps’ features that collect user’s personal information, such as the type of headache, to facilitate personalized tracking and management of headaches.

Subtheme (3.1): apps point out trends in data

Reviewers found it useful when the app extrapolated data from previously logged headache information to identify potential triggers, map out patterns, or characterize effective treatments that have been logged. Many users admire that apps often validate headache by giving a sense of community, helping users to feel understood by other headache patients, or better understanding their own headaches through evidence within the app. Apps such as Migraine Buddy provide forums for migraine patients to connect with other users and send encouraging messages such as “you are not alone” and “feel better.”

Subtheme (3.2): customization by collection of user’s personal information

Several user reviews mentioned if the app could be customized using the user’s specific headache symptoms, triggers or medications. For example, users praised the ability to add specific medications or triggers that are recorded frequently. In addition to traditional features tailored to headache patients, users praised an app’s overall layout and design if the app could also be customized to suit their own preferences.

Subtheme (3.3): app provides relief

Many reviews underscore when an app provides relief as users often experience fewer or less intense headaches after regular app usage. This may be due to lifestyle changes made from insights drawn from the app, or the addition of meditation or relaxation exercises either included in or suggested by the app.

Theme 4: Ease with exportation and viewing data is critical

Several users highlight the app’s ability to view and export data easily. This is an important feature for users because data reports facilitate better communication with physicians.

Subtheme (4.1): app generates data reports

Users compliment the app’s ability to generate detailed data reports or summaries of their headache attacks for easy visualization of this data. These apps have the ability to export or share data reports with others for maximum usability by users, physicians, and others who are important in treating their headaches.

Subtheme (4.2) app assists doctors in better treating user’s headaches

Data reports, charts, tables, and exportation features are integral for users to show their headache attack history to their physicians during routine appointments, which can aid in accelerating the identification of effective treatments. User reviews also suggest that many doctors now recommend smart-phone based headache diary apps to effectively monitor and track headaches. Some reviews describe an app’s ability to assist the doctor in the development of a patient’s treatment plan.

Discussion:

Given the high prevalence of migraine and the large number of apps available for commercial use, this study generated many user-centered suggestions for features to be included in headache apps. Overall, people with headache prefer an app with an easy-to-use interface to record various details about their headaches such as triggers, treatments, and other headache information. Additionally, users appreciated apps that had tools to facilitate an understanding of their headaches, or apps that were intuitive enough to help identify and predict triggers or patterns in their headaches. Many users also pointed out the need for personalization of the app to allow customization according to their own headache experiences and preferences. Users also highlighted whether the app provided relief with their headaches using exercises, suggestions, or even a social headache community that validates their headaches and experiences. Most importantly, apps should allow for easy data visualization for both patients and doctors with data reports including key graphs or tables.

We observed that patients who became frustrated with an app had likely encountered technical issues. Apps that crashed, glitched or lost data records had more negative reviews. Complaints about too many notifications, or the app asking too many questions made some users feel overwhelmed. Users who kept having trouble recording their headaches or retrieving their data reports ended up either deleting the app or using it infrequently. However, reviews indicate that users appreciate fast customer service and developers who incorporated user feedback in improving apps.

The perceived needs for headache patients to monitor their headaches may be different from the physicians’ needs to effectively treat the patient’s headaches. Patients may focus less on the 3F’s described in the Delphi study and focus more on app intuition, identification of triggers, and app personalization. Thus, the following themes may be more important to patients than physicians: App usability; Personalization and features to assess trends in data are key motivators for app use; Ease with exportation and viewing data is critical. The discrepancy between patient and physician requirements for a headache app can be attributed to differences in patient and physician motivation for using the app. While physicians may understand the importance of all of our themes towards treating headache, they mainly need data on the 3F’s to correctly diagnose and treat patients, all of which are mentioned under (1) App allows users to track headache characteristics, potential triggers, and treatments. On the other hand, patients are oftentimes motivated to make lifestyle changes or follow behavioral therapy recommendations that may help improve headaches to supplement physician medications and treatments.¹ In line with the Delphi study, our study supports the need for an app that might generate two reports: one for the patient (customized to provide details on specific headache information), and another for physicians (solely including the 3F’s).

Similarities can be seen between our study and other findings examining mobile health apps developed for health conditions. An analysis of 1287 user reviews of 31 cognitive behavioral therapy (CBT) apps for depression reported that users placed importance on app features such as customization, the ability to share recorded data with doctors, and the presence of an online community.⁷ Another study that qualitatively reviewed consumer reviews for mobile apps for bipolar disorder revealed similar themes, such as ease of use, suggestions, technical issues, community within the app, and the therapeutic effects within the app.⁸ Personalization, ease of use, and tracking were also highlighted in a qualitative review of a focus group study on physical activity app.⁹ Additionally, a systematic review of users’ perceptions of mobile health apps for chronic diseases revealed that most users were motivated to use an app if it was easy to use, simple and visually appealing.¹⁰ User motivation is also reliant on key support from a clinician, who could help facilitate the use of the app as a tool for managing chronic conditions.¹⁰

Despite having a consumer perspective on headache apps, this study has some limitations. Only 11 different apps met the inclusion criteria, with 4 of these apps having both Android and IOS versions. A priori a decision was made to extract an equal number of reviews from each app. A majority of the app reviews came from Migraine Buddy due to the app’s disproportionately large user base. In addition, several of the apps did not have the maximum number of reviews that could be extracted. Thus, even though we had a large sample (N=945) of reviews coded, there is some bias in the codes due to the unequal distribution of reviews from each app. Also, we could not address the issue of potentially fabricated reviews. A few app reviews for some of the apps seemed to include suspiciously obvious, disingenuous, and repetitive language that could have been fabricated by someone who did not use the app. There was no scientific way to verify the authenticity of the reviews. Additionally, since these apps were not downloaded by our coders, a verification of the functions within the app according to the reviews was not done.

Conclusions

Overall, this study highlights the importance of an app-based headache diary for migraine management that is designed considering the needs and concerns of the users and physicians. Headache apps should have a user-centered design with the ability to (1) customize key features including headache characteristics, potential triggers and treatments, (2) evaluate trends in data and (3) view and export the data.

Based on our observations, we recommend that app designers and physicians create an app that asks important questions about headache attacks. The app should include three separate sections within a headache app: 1) A monthly calendar view with symbols to indicate headache characteristics and medications taken. 2) A graph and trends section of the app with the frequency, severity, and medications taken per month and year. This section would align well with the information needed by physicians while still presenting interpretable data for the patient. 3) A section on evidence-based migraine management tools. This section aligns well with patients’ desires to understand ways of alleviating headaches without physician help. Finally, a feature should be included to generate reports for either patients or physicians that can be used for easy exporting and sharing functionality.

Future research might examine whether there are associations between the costs of headache tracking apps (free versus paid) and consumer attitudes or expectations. In addition, future work might examine how factors such as the cost of the app affect user engagement.

Table 5:

Sample reviewer quotes, separated by theme and subtheme.

(1) USERS WANT THE ABILITY TO TRACK HEADACHE CHARACTERISTICS, POTENTIAL TRIGGERS, AND TREATMENTS
(1.1) Track triggers
“It tracks all kinds of important things that you input data about. It can track when you fell asleep to when you wake up, you can input certain food choices and it helps track whether or not that food is a migraine trigger, information about migraine and surveys that are optional to fill out, and It’s got several chat rooms. It also has a very thorough system of questions for when you record an attack. Exact times, your location, triggers like light/sound/auras/ jaw pain and it even shows you the weather and the humidity during that hour. It’s a great app for tracking migraines!”
“This app has been really helpful to keep track of triggers/what helps. Taking less pain relief and believe I’m experiencing fewer headaches as a result.”
(1.2) Track treatments
“…Once in the habit of logging and tracking every attack, the fact that you can add your own triggers, reliefs, medications… You can re-arrange your icons. monitor your sleep patterns, weather and other things that can affect you.…”
(1.3) Track headache information
“…It has a nice, easy to use head graphic that lets you specify multiple pain regions. You can continuously track an ongoing headache without needing to start a new one.”
(1.4) Users suggest features to log relevant information
“An ‘end’ date/time would be helpful as migraine patients usually go beyond hours to multiple days and the weekly view only shows the record for when the headache started.”
“…the app needs more details like a symptom tracker. Such as nausea, light sensitivity, vertigo, tinnitus, aura, etc. Also the diagram of the head to pinpoint pain areas beads to be broken down a little more. For instance my migraines are primarily on the left side of my head all the way to above my left eye.”

(2) APP USABILITY IS ESSENTIAL
(2.1) Apps allow viewing/editing of existing records
“…I originally started using it for documentation for my doctor, but it’s grown into so much more. Each screen has easy choices to choose from, and you can customize which is outstanding! If you’re in too much pain you can skip and come back later, or allow Alexa to help!…”
“…I really appreciate that putting in a new episode is simply a matter of going through a grid of pictorial icons. Best of all I can add my own if I’m having a symptom or using a treatment that isn’t listed.”
(2.2) Design features for migraine sufferers are appreciated
“…when viewing all records the notes column is too narrow…; when adding a new trigger or drug to the list, any previously ticked ones have to be re-ticked because the info is lost…”.
“…The app anticipates high pressure days, reminds me to record triggers, and tracks my progress of migraines/ headaches for months…”
(2.3) Developer services satisfy customers
“I was told that after 90 days, my individual maps would be available so I could see my triggers. Every time I try to open the mapsthe app shuts off. What is the point of imputing daily information if I can’t get to the maps, which are supposed to be the helpful part of the app??”
“It lost a lot of information I entered about a headache because I hit the wrong button… people with migraines might not be feeling or thinking the best when they fill out details in the app. It should be harder to lose details and data, easier to enter times and days, and easier to side scroll the timeline of symptoms to specific points and see where you’re at.”
(2.4) Technical difficulties limit app usage
“…The kind developers of this application have done a wonderful job figuring out for us how to simplify the tracking. The customer service is wonderful. I had trouble figuring out how to do a certain part, and they not only replied within 24 hours…included a video on what I needed to do…”

(3) PERSONALIZATION AND FEATURES TO ASSESS TRENDS IN DATA ARE KEY MOTIVATORS FOR APP USE
(3.1) Apps point out trends in data
“…The app has revealed trends that contrast with my memory: For example, I thought my headaches correlated with PMS and happened most often on weekends, when in fact most of them occur after PMS and during the work week. It also gives basic trends on which treatments I note as \”helpful\” most often…”
“I always thought my migraines were something no one else really suffered from. I now realize that this is an actual community with real people who go through what I go through everyday…The simple “you are not alone” message when I’m having a really bad attack helps in many ways that I can’t describe…”
(3.2) Customization by collection of user’s personal information
“…This App is very flexible by allowing you to select your own triggers…places that icon on for your future use. I added Nitrites and MSG…You can also put in a note. If my note for an attack says I ate at xyz and this shows up over and over, then that’s a big clue to go somewhere else…”
“…The interface is incredibly intuitive and simple…You can also customize many screens to be even better and more relevant to your pain and relief systems, which is also an incredibly easy process to do…”
(3.3) App provides relief
“Ease taught me exercises and techniques that I had never considered before as an option to help with my headaches and migraines…The relaxation exercises and information.…helped me reduce the frequency of my headaches by almost half so far. …”

(4) EASE WITH EXPORTATION AND VIEWING OF DATA IS CRITICAL
(4.1) App generates data reports
“The reports collect, redistribute and display the data and information so that you can more easily see trends and commonalities.”
“This is an extremely useful app that collects, organizes, and beautifully displays your headache data with the ability to export.”
“An entire report based on my pain pattern was created by the app that helped me create a migraine tracker to show my doctor in order to get the right treatment for my pain.”
(4.2) App assists doctors in better treating user’s headaches
“This app helped my doctor develop a more comprehensive treatment plan that is working wonderfully so far…”
“…My doctor showed me this app and asked me to use it. It is easy and helps to track patterns. It also helps my doctor to continue to justify my migraine treatment with the evil insurance company…”