title: Predictive model for the Migraine-ACT questionnaire in primary care.
abstract: BACKGROUND
  Migraine is frequently under-treated. The 4-item Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire is a simple, patient-friendly tool to identify patients requiring change in acute migraine treatment.
  
  
  OBJECTIVE
  To establish a predictive model for the Migraine-ACT questionnaire in primary care.
  
  
  METHODS
  This open-label, prospective, two-visit study at 1100 primary care sites enrolled patients reporting migraine for > 1 year and > or = 1 migraine attack/month. Predictive validity of the Migraine-ACT questionnaire was evaluated using a logistic regression model adjusted for baseline disability, diagnosis, sex, age, attack frequency, attack duration, baseline treatment change, treatment(s) for the study period and baseline Migraine-ACT score.
  
  
  RESULTS
  A total of 3272 patients, 78% female, entered the study and 2877 patients (88%) returned at 3 months. Investigators changed baseline migraine treatment for 72% of returning patients. Percentages of patients who were completely or very satisfied with migraine therapy increased from 15% at baseline to 49% at 3 months. The adjusted logistics regression model yielded sensitivity of 86% and specificity of 85% to detect > or = 1-point change in Migraine-ACT score at 3 months (p < 0.001). The model yielded 77% sensitivity and 95% specificity to detect > or = 1-point improvement in patient satisfaction at 3 months among patients who improved > or = 1 point in the Migraine-ACT score (adjusted odds ratio, 2.63; 95% confidence interval, 1.97-3.51; p < 0.001).
  
  
  CONCLUSIONS
  The Migraine-ACT questionnaire is a simple but sensitive and specific tool to predict improvements at 3 months resulting from changes in migraine treatment and can be used to detect patients with suboptimal migraine management and to monitor treatment effectiveness.
authors.affiliation: Neurology Service, Hospital Universitario de Salamanca, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual
authors.forename: Miguel J A
authors.initials: MJ
authors.lastname: Láinez
authors.forename: Vicente
authors.initials: V
authors.lastname: Baos
authors.forename: María Luisa
authors.initials: ML
authors.lastname: García
authors.forename: Arturo
authors.initials: A
authors.lastname: López-Gil
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis*; D011320:Primary Health Care; D011379:Prognosis; D011795:Surveys and Questionnaires / Q000592:standards*