title: Responsiveness of migraine-ACT and MIDAS questionnaires for assessing migraine therapy.
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 >or=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 (kappa = 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.
authors.affiliation: CS Mendiguchía Carriche, Primary Care, Madrid, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: García
authors.forename: Vicente
authors.initials: V
authors.lastname: Baos
authors.forename: Miguel
authors.initials: M
authors.lastname: Láinez
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual
authors.forename: Arturo
authors.initials: A
authors.lastname: López-Gil
mesh_terms: D019540:Area Under Curve; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D017060:Patient Satisfaction; D012680:Sensitivity and Specificity; D013030:Spain; D011795:Surveys and Questionnaires; D054928:Validation Studies as Topic