The new migraine app – the service page

Here you can download the migraine app for free in the professional full version from your app store. Or simply use the QR code:

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Radio Podcast – The Migraine App: Application and Scientific Analysis

I am absolutely thrilled. This app helps me a lot in everyday life!!! I can stick to the 10/20 rule so much better because the traffic lights warn early. The built-in progressive muscle relaxation is particularly helpful. I can only recommend the app to every migraine sufferer.
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Quick and clear, and the great thing: I can quickly send my migraine calendar by email to the doctor treating me.
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Since the cell phone is always at hand, no entry will be forgotten anymore. Great!
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This app helped me get my headaches under control. I think the reminder function for relaxation exercises is great!
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This app is great for people who really struggle with migraines, I can always note when I had them and what I took. Top!
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This app helped me get my headaches under control. I think the reminder function for relaxation exercises is great!
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For me it's the best way to keep an eye on my migraines and painkiller consumption. I really like the app!
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Thank you for this great app. Lots of helpful information and really easy to use. Even my doctor was excited when I showed him the app. I'm very happy that I can now simply enter all the data into my cell phone at any time instead of having to write everything down on paper as before. The evaluation provides a quick and clear evaluation of the month. Please continue!
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Since the cell phone is always at hand, no entry will be forgotten anymore. Great!
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It's hard to beat such a well-thought-out, helpful, pleasantly beautifully designed, ad-free app with a maximum of information. It would even be fun to dive through the many areas if the topic weren't so unpleasant. This service is free and well-founded and reveals a big heart for those affected behind the software. Thank you very much for that. Thank you for the great work you have done and are doing with this. This is not a given.
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Super simple, quick and clear. It couldn't be better. Thank you very much for this app and your tireless commitment to migraine sufferers. I also think it's nice that this app not only contains a headache calendar, but that it also provides a lot of information and I can also access the headbook self-help group directly from here. Thanks so much!
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Very useful to get an overview of not only the attacks but also the effectiveness of the painkillers! The operation is simple and very intuitive. The evaluation function is also excellent if you want to understand how frequently attacks occur and how long they last. I can only warmly recommend this app for migraine sufferers.
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The app gives me a very good overview of what is currently going on and where I currently stand with the 10/20 rule. It is definitely a good tool for discussions with my doctor.
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I've been using the app for 10 months now and I'm getting along very well with it and the pain therapist is also finding out about it????. In particular, the 10/20 limit becomes more transparent in the 30-day overview than the previous monthly average. I find the attached information very clear.
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Very good app. Recording migraines and headaches is very useful. You can find help and useful information in the app itself. A must for every headache sufferer!
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I'm excited. I no longer have to look for annoying pieces of paper and therefore don't forget any more entries. Particularly noteworthy is the ad-free use, which gives me the feeling that my health insurance contribution is of benefit to me, and not just in acute cases. I find the view very appealing and the overview is excellently structured. Finally, I would like to suggest that you offer the duration of the pain as a period of time (from - to pm) which can be edited later, as at the time of my entry I cannot yet estimate how long the pain will last. Keep it up!!!!
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I think the app is great. I now finally have a good overview and can give precise information about everything when I visit a neurologist. Everything important is recorded and evaluated very precisely. Keep it up ;)
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I am very satisfied with this app. Gives a very good overview of the type of headache, duration and painkiller effectiveness. Thanks for this thoughtful help!
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I have had severe chronic migraines for a very long time and find this app excellent. It helps me take my battery medication and I have better control over the duration, length and frequency of my migraines. The feeling is often different. There are also helpful additional functions. I think the app is very good and can only recommend it.
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I am very satisfied with this app. Gives a very good overview of the type of headache, duration and painkiller effectiveness. Thanks for this thoughtful help!
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Latest news about the migraine app update 04/2020

This major update adds many new features and optimizations, including:

• New score for the degree of disability caused by headaches (GdBK score)
• Prospective assessment of the impairment of work, family and social life caused by headaches
• Prospective recording of the degree of disability caused by headaches (GdBK score)
• New reminder function for preventative medications
• New reminder function for data backup and backup
• Updating the medication database
• Updating the media library and information tools
• Adaptations to current operating systems
• Numerous optimizations of functions in detail and much more!
• Find out more in the video instructions (selection in the menu) so that you know and can use the extensive functions.

The current migraine update 04/2020 from April 6, 2020 provides many new functions and optimizations. The migraine app is a digital care offer that is directly integrated into professional medical care. Both patients and the treating doctors should be supported. To ensure that a direct route to the data analyzes created by the migraine app is possible during medical consultations, a direct link to the consultation checklists has been added to the overview page.

New consultation checklists for the doctor

Using quantitative progress parameters, it is possible for patients and doctors to optimize the therapy adjustment, control the progress and increase the effectiveness of the treatment measure. For this purpose, the consultation checklist was integrated into the migraine app. It can be accessed directly via the app's overview page by the patient or doctor in the cockpit. Here you can find the consultation hour checklist with the summarized data sets for the current year and the previous year. If desired, this analysis can be exported as a PDF form, for example via email, and integrated into the doctor's practice information system. This also makes it possible to store the data in the electronic patient file. Data retrieval can only take place actively with authorization from the patient.

Analysis of headache characteristics

The annual evaluation shows the aggregated data sets for the respective month of the year. In the first four columns, different headache phenotypes are differentiated. Column A contains the days with a migraine aura, column M the days with a migraine, column S the days with a tension-type headache, and column U for other undetermined types of headache. Migraines and tension-type headaches are responsible for approximately 92% of all headaches in the population. Therefore, the migraine app focuses on these two main forms. If other headache forms that do not correspond to these phenotypes are present, they are subsumed in the U column, ie, undetermined type. Because the International Headache Classification differentiates 367 major types of headaches, it is not possible to meaningfully document all headache phenotypes and headache subtypes.

Assessment of headache-related disability

Using the migraine app requires a trained patient who can differentiate the type of headache they have in everyday life. Since the patient also needs to know in everyday life which type of headache he should use which acute therapy or other treatment measures, differentiating the headache phenotype is a prerequisite for professional treatment. Therefore, the migraine app does not need to prospectively query all features of the headache phenotype for each attack, as this decision is made by the patient. The patient enters the relevant characteristics in the “Quick Entry” menu and also documents the severity, duration, type of acute medication used and its effectiveness. At the same time, he documents the effects of the headache on work activities, household activities and leisure activities. The migraine app progressively records the degree of impact on these areas of activity. A restriction of activity by more than 50% is documented to record the degree of disability caused by headaches. The migraine app also records whether activity is completely impossible in the respective area due to headaches. If this affects work, a day of incapacity for work is recorded. If household or leisure activities are made completely impossible, this will be documented as 100% impairment. The days of impairment caused by the headache are summed up per month and shown in the last column as GdBK points, as the degree of disability caused by the headache. This means that the patient and doctor receive a direct picture of the disability caused by the headache in the respective month. This score is calculated analogously to the MIDAS score. In contrast to the MIDAS score, however, the data is continuously collected prospectively, so the reliability is significantly higher. The MIDAS score records the corresponding impairments retrospectively from memory for a period of three months. It is evident that the value obtained in this way is much more prone to errors. The analysis of the progression parameters collected in this way can now be used directly to make treatment decisions. A significant decrease in the number of migraine days per month by at least 50% can operationally prove the effect of a chosen headache prophylaxis. The treating doctor can see directly whether, for example, the selected medication is effective or whether therapy needs to be adjusted by increasing the dose or changing the medication. By analyzing the number of headache days per month, the development of chronic migraines can also be mapped. If the sum of migraine days and days with other headaches is 15 or higher over a period of more than three months, the diagnosis of chronic migraine may be justified.

Analysis of the severity and duration of headache attacks

Whether the headache therapy is effective over time can also be determined by the severity and duration of the headache attacks. The sum of the individual values ​​per month is calculated for the severity and duration and at the same time an average is calculated. The severity of the headache is documented with a score (0= none, 1= mild, 2= moderate, 3= severe, 4= very severe). The respective graduations are described in the legend on the evaluation PDF. A reduction in the average severity and a reduction in the average duration of headache attacks can be used as an effectiveness of preventive treatment as well as acute treatment.

Analysis of drug effects

The operational assessment of the effect of acute therapy can be carried out by analyzing the effect of the medication. First, the days of intake for acute therapy are shown for each month. The decrease in the need for acute medication can also be interpreted as an indication of effective prophylaxis. On the other hand, an increase or even an increase in the number of days taken per month over 10 or more days per month can be seen as an indication of increasing chronicity and the development of a medication overuse headache. Here it is important to discuss in detail with the patient that the 10-20 rule must be adhered to and that exceeding the 10 limit promotes further chronicity. Simply by pointing out an appropriate limit on the amount of acute medication taken per month and possibly being instructed on how to take a medication break can significantly stabilize and improve the headache.

The effect of acute medication can be determined using the medication effect. For this purpose, a score for the medication effect is shown. The drug effect (grading 0= no effect, 1= weak, 2= medium, 3= good, 4= very good) shows an effect of 0 in the worst case and an effect of 4 in the best case. Ideally, a score between 3- 4, ie good to very good, is the aim. If the score is below 3, an adjustment of acute therapy should be considered.

Degree of headache impairment: GdBK score

The effects of headaches on activities at work, school and studies are particularly relevant for assessing the severity of the headache. This also applies to the impact on household activities as well as on leisure and social activities. The migraine app continuously and prospectively documents the degree of impairment caused by the headache for the respective areas and aggregates this data monthly. For each month, the sum of the affected areas of activity is created into an overall score. This overall score is referred to as the GDBK point score and quantitatively reflects the degree of impairment caused by headaches. The GDBK points can therefore directly quantify the headache-related impairments for the respective month. The increase or significant decrease can directly and quantitatively document the effectiveness of the headache treatment and the effects of the headache on the quality of life in the follow-up. A reduction in the GdBK score of 30% or more can be considered a clinically significant improvement.

The consultation checklist makes it possible for doctors and patients to immediately track headache symptoms over the last few months and to make individual, data-based therapy adjustments. However, it is essential that the doctor can make an appropriate interpretation of the data pattern. If the migraine app is trained accordingly, the migraine app is an objective tool for analyzing the course of the disease and optimizing therapy in care for both the patient and the doctor.

Reminder function for preventive medication

Numerous new functions have been added for the patient himself. In the “Settings” menu there is a reminder function for preventative medications. The migraine app reminds you to take medication. To do this, it sends a pop-up to the mobile phone informing the user about taking medication at the relevant time. The reminder function can be selected depending on the frequency of intake, e.g. daily intake, multiple daily intake, monthly intake or intake every 4 weeks or every 12 weeks, etc.

Data backup reminder function

Furthermore, a reminder function for data backup and data backup has been installed. The migraine app reminds you to back up your data every four weeks. To do this, you send the database to your own email account. If the mobile phone is lost, this database can be read in directly during a new installation and the collected data will not be lost.

Updated medication database

The medication database installed in the migraine app has also been updated and contains the current medications relevant to migraine and headache therapy.

Update media library and information tools

The Migraine app's media library and information tools have also been updated and expanded.

Adaptation to current operating system versions

Technical changes concern adjustments to the current operating system versions and numerous optimizations of functions in detail.

Video instructions help to optimize usage

To understand all the functions of the migraine app, you should watch the video instructions step by step.
This makes it possible to use and know the extensive professional functions of the migraine app. If you have any questions about this new update, you can reach us at app@krebsklinik.de .
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The migraine app was developed in collaboration with specialized doctors, headache scientists, care experts from the Techniker Krankenkasse and self-help groups who work in the practical care of migraine and headache patients in the nationwide headache treatment network. The main focus during development was on digital support for professional, coordinated care in the nationwide headache treatment network. The migraine app documents the course of migraines and headaches with active data entry. It reports aggregated information from the data set and thus helps patients and the doctors in charge to monitor progress and success as well as adjust therapy. The migraine app contains reporting, information and self-help tools. It is the first app that is directly integrated into medical treatment and therapy through an addition to a care contract in accordance with Section 140a ff SGB V for integrated care of migraines and headaches. The main goals are professional documentation of the course of the disease, increasing adherence to therapy, digital documentation and support of the treatment under medical supervision, motivation for therapy and the transfer of information and knowledge about the clinical picture, including the digital networking of those affected nationwide through self-help communities. Data protection is guaranteed. The detailed one Data protection declaration can be found here.

The extensive experiences of the users were implemented in a comprehensive update with numerous extensions, e.g. b.

• Live visualization of a migraine aura in the current environment
• Visualization of different migraine aura types
• New short version (15 minutes) of progressive muscle relaxation for adults
• The feedback and reward system for progressive muscle relaxation has been improved
• Update of the headache expert map in the nationwide headache treatment network
• The evaluation PDF is expanded
• The complete current international headache classification ICHD-3 with all types of headaches is integrated
• Export function for data backup and transfer to another device: step by step instructions here
• Import function for transferring from another device
• Transfer data from Android to iOS and iOS to Android
• When entering acute medication, the 10/20 switch button can be used to determine whether medication is relevant for the 10/20 rule
• Adjustments for iPhone X and Apple Watch 3
• Warning when making entries for the future
• Numerous optimizations of functions in detail
• and much more!

If you have any questions about this new update, you can reach app@krebsklinik.de

Some users of the Migraine app on Android ask what to do if the Migraine app reports when they open files (e.g. pdfs, mp3, wav, etc.) or links. This is a basic behavior of Android when there are multiple apps for a function - such as opening a PDF or displaying a photo. Android will give you two options when opening it for the first time: Now only open it once with this app, or always by default. Since the Migraine app needs to be able to open music files, videos, PDFs and the backup file, your operating system may suggest that the Migraine app opens such files even though you don't want it to. Some users who are not familiar with this operating system function suspect that this is a bug in the Migraine app. This is not the case, but a peculiarity of Android to offer you as many choices and degrees of freedom as possible. How to set up or delete default apps on Android can be found here in more detail:

https://support.google.com/android/answer/9415055?hl=de

However, you can do this much more easily with the Better Open With Android app. You can find the app for free here in the Google Play Store

The Better Open With app replaces the basic Android choice and also expands it: you can choose a default app to open if you haven't chosen another one after a specified time. Currently the app can be activated for various common programs and file types - currently music and video players, music and video streams, as well as PDF readers and browsers. For example, if your operating system wants to open PDFs with the Migraine app or another app, but you want to see a specific app as the default app for opening, you can simply specify this and exclude the Migraine app. If you have many different apps on your device, you will really appreciate “Better Open With”.

In these click tips, Prof. Hartmut Göbel explains the diverse functions of the migraine app. Take some time for this. The migraine app is a comprehensive professional tool for information, progress and success monitoring of your migraine and headache therapy. With these instructions you will be able to use the numerous possibilities professionally.

The migraine app

Tension-type headaches and migraines are the second and third most common human diseases behind dental caries [1]. The one-year prevalence for all types of headache is 86% in women and 71.1% in men, for migraine 43.6% in women and 26.9% in men, and for tension-type headache 35.7% in women and 40.7 % in men and for medication overuse headache 4.3% in women and 1.8% in men. Chronic headaches with more than 15 headache days per month occur in 9.5% of women and 4.9% of men (4). Migraine is the most common and significant cause of disability in people under 50 [2]. Headache disorders are responsible for more than 75% of all years of disability due to neurological diseases, including, among others, stroke, dementia, Parkinson's disease, multiple sclerosis and epilepsy [2]. Migraine, just one of the 367 headache disorders known today, ranks second among the diseases that cause the most years of disability in the population [2]. Every day around 900,000 people in Germany are affected by migraine attacks. 100,000 people are unable to work and bedridden every day because of migraine attacks. On average, 3 million Germans take a headache tablet every day through self-medication. 58,853 single doses of triptan are taken every day in Germany to treat migraine attacks [3]. Headaches are one of the most common reasons for short-term inability to work. The number of days missed per year due to migraines alone corresponds to the annual working hours of 185,000 full-time employees with an estimated cost of 3.5 billion euros [4]. In addition, there is the loss of productivity due to unpaid work in the household, in raising children or in caring for relatives. The risk of depression, anxiety disorders and suicide is 3-7 times higher in migraine patients [5], and the risk of cardiovascular disease, heart attack and stroke is 1.5-2 times higher than in healthy people [6]. Less than 20% of those affected in Europe receive medical care, and less than 10% receive guideline-based prevention or acute therapy [7].

The prerequisite for individually adapted and operationalized headache therapy is self-observation and documentation of the headache to monitor its progress and success. Keeping a headache diary was therefore included in guidelines for headache treatment at an early stage [8]. Recording the number of headache days per month, the duration of the headache attacks, the characteristics of the headache phenotype with qualitative and quantitative documentation of the pain parameters and accompanying symptoms, as well as medication intake are necessary in order to be able to make justified therapeutic decisions and adjustments on this basis. However, pain calendars and pain diaries have a number of disadvantages. Information entry is static, data is recorded using paper and pen, documentation is limited and is often misplaced or forgotten.

The introduction of smartphones made it possible to use software applications (apps) and connect to the Internet and other data networks. The use of apps in medicine was one of the earliest professional applications of mobile computing technology. They were therefore used early on to monitor the progress and success of pain and headache therapy [9-12]. Mobile software applications have a number of advantages over paper documentation. The smartphone is usually carried with you at all times and is today's central communication device for over 80 percent of the population. The documentation of the headache phenotype and the course of the headache over time can therefore take place immediately. Progress parameters can be entered directly into the app. Current information about environmental variables such as air temperature, air pressure and whereabouts can be digitally recorded automatically. The smartphone can use the data to digitally generate clear, aggregated reports that can be used directly and do not have to be counted in a lengthy manner. Monitoring progress and success using smartphone applications has proven to be more reliable than paper documentation. They show higher compliance compared to paper diaries [13]. Scientific data shows that the compliance rate for electronic diaries is 94%, while for paper diaries it is only 11% [14].

The concept of the migraine app focuses on professional documentation and support for the practical care of migraine and headache patients. Both those affected and the professional groups providing treatment should be supported. On the start screen, the migraine app shows, in the style of cockpit display instruments, aggregated documentation of the headache progression over the last 30 days as well as summary information on headache frequencies over the last 6 months. The headache days per month, the number of days with acute medication and the effectiveness of the attack therapy are presented quantitatively and qualitatively in the form of display instruments. The effectiveness of the attack therapy as well as the effectiveness of the prevention is reported back to both the user and the treating doctor in aggregate. The respective headache days are documented using quick entry. The date, the headache phenotype, the headache intensity, the headache duration, accompanying events such as aggravation by physical activity, nausea or vomiting, hindrance to planned activities and aura symptoms are documented. The current weather data on the day of the headache and location are automatically added digitally. The type of acute therapy and its effectiveness are also documented. Additional comments can be entered freely. The data is documented in the pain calendar and can be adjusted there if necessary. To record acute medication and preventive medication, the medications used can either be selected from a database or entered freely. A detailed report provides summary information about the days with a migraine aura, migraine headaches, tension-type headaches or other types of headaches, either for the respective month of treatment or for the respective year of treatment. The severity, duration and number of days with medication as well as the effectiveness of the acute medication are quantitatively reflected. The MIDAS score to record migraine-related disability is documented every three months. Further tools in the migraine app include an aura simulation, the presentation of different aura types to provide information about the occurrence of migraine auras, scales to record chronicity, the optimal time to take acute medication and documentation of the characteristics of the most important types of headache. Using an expert search, headache experts can be found nationwide in the nationwide headache treatment network using a navigation tool. A long and a short form of progressive muscle relaxation is available for adults as well as adolescents and children. In addition, the migraine app contains links to detailed headache coaching, a headache video library, an extensive library of headache knowledge and the digital version of the current international headache classification ICHD-3. Those affected are networked via social communities (headbook community, migraine Facebook community) with currently more than 30,000 users. In addition, live chats with headache experts are possible at fixed intervals via the migraine app. The migraine app reminds you to carry out progressive muscle relaxation regularly and includes a reward system for it. The migraine app also has a backup and export function. The Migraine app data is stored exclusively on the local device. No registration is required. Only the user has access to the data. He alone is able to create a report and, if necessary, send it to the treating doctor.

Important note: The migraine app cannot replace diagnosis, advice and treatment by a doctor. It is not suitable for the independent diagnosis or treatment of diseases.

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Counting steps, checking messages, checking appointments – digital timepieces can do more than just display the time and date. Now the first health applications reach the wrist: The Apple Watch, the first intelligent watch, now supports the self-management of chronic headaches. This is made possible by the therapy-supporting migraine app, which is being developed at the Kiel Pain Clinic under the direction of Prof. Dr. Hartmut Göbel was developed and is made available nationwide in cooperation with the Techniker Krankenkasse (TK). With the help of the migraine app, you can, among other things, document pain patterns and medication intake, explore types of headaches and identify possible reasons for intervention within therapy. Since its launch in December 2016, more than 10,000 people have already used this freely available and free application, initially on an iOS basis. This will also be available for Android from spring. It is specifically tailored to the needs of migraine and headache patients and not only records the course on a scientific basis with active data entry. It analyzes these, informs the user and reacts appropriately to alarming signals. The app also provides information about active behavioral measures and shows how the desired health goal can be achieved under medical supervision. It was developed based on decades of experience by specialized scientists, care experts and those affected.

Self-management with just one tap

Headache characteristics can now be recorded on the smartwatch with a tap on the wrist, without having to reach for a smartphone. The course of treatment is analyzed individually. The migraine app - unique in the world - provides migraine and headache patients with an immediate analysis of the course and success of the doctor-led treatment with a connection to the Apple Watch.

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Migraines and other forms of headache are epidemiologically among the most common and, after dementia and stroke, among the third most expensive diseases of the nervous system. They are one of the most common reasons for doctor visits and inpatient emergency admissions and cause serious disabilities and complications. Worldwide, more than 46 percent of the adult population suffers from an active headache disorder, eleven percent from migraines, 42 percent from tension-type headaches and three percent from daily persistent headaches. Headaches take third place on the World Health Organization's (WHO) list of the most disabling diseases. Around a million people in Germany alone suffer from migraine attacks every day. Of these, 100,000 are bedridden every day. Epidemiological studies in recent years have confirmed that migraine is associated with an increased risk of stroke, heart attack and other diseases of the cardiovascular system. In Germany, an average of 8.3 million people take headache medication every day for severe headaches. But treating headaches with medication also has a downside: Anyone who takes pain medication for more than ten days every month runs the risk of developing a headache from the medication itself. For this reason, pain doctors rely on self-management and patient responsibility for chronic headache disorders such as migraines. The migraine app from the Kiel Pain Clinic offers a suitable tool for this purpose, in which only the patient decides with whom they share their data and experiences alongside the treating doctor. The TK has no access to the data.

 Note for editors:

Further information about TK's digital offerings can be found at www.tk.de , web code 723220. Information about the app from the Kiel Pain Clinic can be found at https://krebsklinik.de/2016/10/01/die-migraene-app/ . The migraine app with all content can downloaded as a full version free of charge from the Apple Store . An Android version is in preparation and will also be available free of charge with all content as a full version in the first quarter of 2017.

February 23, 2017

You can find more information about digital medicine and the migraine app on the Techniker Krankenkasse information pages .

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