Concise headache axis for systematic reporting: needs assessment in Indonesian neurology residents

Resumo

Purpose
This study aimed to refine and simplify the existing standardized headache reporting axis used in Indonesian neurology training, addressing challenges in usability, efficiency, and diagnostic clarity while maintaining essential clinical detail.
Methods
A qualitative needs assessment was conducted through a focus group discussion involving six neurology residents with experience in headache management at a national referral hospital. Data were collected through a structured, moderator-led discussion, transcribed verbatim, and analyzed thematically using the Steps for Coding and Theorization (SCAT) method to identify core themes and recommendations for revision.
Results
Four major themes emerged: (1) benefits of standardized and systematic reporting; (2) challenges and barriers in documentation; (3) variability and the need for contextual adaptation across clinical settings; and (4) recommendations for simplification and efficiency. Key revisions included merging quality with phenotype, combining severity with functional status, and integrating aura and autonomic symptoms under associated symptoms. The updated axis emphasizes essential dromal elements—phenotype, duration, intensity, and location—while incorporating biopsychosocial factors for a more holistic approach. The tool was also designed to accommodate different clinical contexts, including emergency, outpatient, and inpatient settings.
Conclusion
A concise and structured headache documentation framework enhances diagnostic accuracy, therapeutic decision-making, and clinical efficiency. The revised headache axis offers a flexible yet standardized tool potentially adaptable across care settings, supporting both clinical practice and future research in headache management.