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Responsiveness of Migraine-ACT and MIDAS Questionnaires for Assessing Migraine Therapy

Authors

  • María Luisa García MD,

    1. From the CS “Mendiguchía Carriche”—Primary Care, Madrid, Spain (M.L. García); CS Collado Villalba—Primary Care, Madrid, Spain (V. Baos); Hospital Clínico Universitario de Valencia—Neurology, Valencia, Spain (M. Láinez); Hospital Universitario de Salamanca—Neurology, Salamanca, Spain (J. Pascual); MSD Spain—Medical Department, Madrid, Spain (A. López-Gil).
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  • Vicente Baos MD,

    1. From the CS “Mendiguchía Carriche”—Primary Care, Madrid, Spain (M.L. García); CS Collado Villalba—Primary Care, Madrid, Spain (V. Baos); Hospital Clínico Universitario de Valencia—Neurology, Valencia, Spain (M. Láinez); Hospital Universitario de Salamanca—Neurology, Salamanca, Spain (J. Pascual); MSD Spain—Medical Department, Madrid, Spain (A. López-Gil).
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  • Miguel Láinez MD, PhD,

    1. From the CS “Mendiguchía Carriche”—Primary Care, Madrid, Spain (M.L. García); CS Collado Villalba—Primary Care, Madrid, Spain (V. Baos); Hospital Clínico Universitario de Valencia—Neurology, Valencia, Spain (M. Láinez); Hospital Universitario de Salamanca—Neurology, Salamanca, Spain (J. Pascual); MSD Spain—Medical Department, Madrid, Spain (A. López-Gil).
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  • Julio Pascual MD, PhD,

    1. From the CS “Mendiguchía Carriche”—Primary Care, Madrid, Spain (M.L. García); CS Collado Villalba—Primary Care, Madrid, Spain (V. Baos); Hospital Clínico Universitario de Valencia—Neurology, Valencia, Spain (M. Láinez); Hospital Universitario de Salamanca—Neurology, Salamanca, Spain (J. Pascual); MSD Spain—Medical Department, Madrid, Spain (A. López-Gil).
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  • Arturo López-Gil MD, PhD

    1. From the CS “Mendiguchía Carriche”—Primary Care, Madrid, Spain (M.L. García); CS Collado Villalba—Primary Care, Madrid, Spain (V. Baos); Hospital Clínico Universitario de Valencia—Neurology, Valencia, Spain (M. Láinez); Hospital Universitario de Salamanca—Neurology, Salamanca, Spain (J. Pascual); MSD Spain—Medical Department, Madrid, Spain (A. López-Gil).
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  • Conflict of Interest: This study was supported by a grant from MSD Spain; editorial support was provided by Elizabeth Hillyer, with financial support from Merck & Co., Inc. Potential conflicts of interest by the authors, as listed in the Acknowledgments, are as follows: Dr. María Luisa García Fernández has consultant arrangements with AstraZeneca and Merck and has not received grants. Dr. Vicente Baos has received grants from AstraZeneca, GlaxoSmithKline, and Merck. Dr. Miguel J.A. Láinez has received personal compensation or research support from activities with Allergan, Inc., Almirall SA, Ferrer Internacional, Merck & Co., Inc., Medtronic, Pfizer Inc., and Servier SA. Dr. Julio Pascual has consultant agreements with Almirall, MSD, and Allergan. Dr. Arturo López-Gil is an employee of Merck, Sharp, and Dohme of Spain.

A. López-Gil, Medical Department, MSD Spain, c/Josefa Valcarce 38, Madrid 28027, Spain.

Abstract

Background.— Migraine is frequently undertreated. The 4-item Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire is a simple and reliable tool to identify patients requiring a change in current acute migraine treatment.

Objective.— To investigate the responsiveness of the Migraine-ACT tool, and compare it with that of the Migraine Disability Assessment (MIDAS) questionnaire, for patients with migraine at 1100 primary care sites in Spain.

Methods.— Patients eligible for this open-label, 2-visit prospective study reported migraine for >1 year and ≥1 migraine attack per month and were new to the clinic or on follow-up care for <6 months. Validated Spanish versions of the Migraine-ACT and MIDAS questionnaires were administered, and patient satisfaction with treatment was recorded, at baseline and at 3 months.

Results.— A total of 3272 patients, 78% female, were enrolled, and 2877 (88%) returned for the 3-month visit. Investigators changed baseline migraine treatment for 72% of returning patients; 85% and 80% of these patients had improved Migraine-ACT and MIDAS scores at 3 months, respectively. Patients who reported being completely or very satisfied with migraine treatment numbered 492 (15%) at baseline and 1406 (49%) at 3 months. Migraine-ACT and MIDAS score agreement for improvement at 3 months was poor (κ = 0.339). Both the mean MIDAS score and the distribution of Migraine-ACT scores improved over the course of 3 months; however, Migraine-ACT scores were significantly (P < .001) more sensitive (83% vs 75%) and specific (72% vs 58%) than MIDAS scores. The area under the curve in the receiver-operating characteristic analysis was significantly (P < .0001) greater for Migraine-ACT (0.82) as compared with the MIDAS (0.70) questionnaire.

Conclusions.— These results suggest that the Migraine-ACT questionnaire can be used more reliably than the MIDAS questionnaire for detecting improvements in treatment of new and follow-up patients with migraine.

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