Further validation of an individualized migraine treatment satisfaction measure.
OBJECTIVE
To assess individualized satisfaction with migraine treatment, patient expectations, importance rankings, treatment outcomes, and overall satisfaction were combined using a four-part conceptual model. This article describes the measurement properties of the Migraine Treatment Satisfaction Measure (MTSM) using participants from a randomized controlled trial evaluating a Headache Management Program (HMP).


METHODS
Participants completed the first two parts of the MTSM upon enrollment and the final two parts at 6 months. Internal consistency reliability was computed within each of the four modules. Discriminant validity was ascertained using Migraine Disability Assessment Survey (MIDAS), Patient Health Questionnaire-9, and MSFB scores. Convergent validity was established by hypothesized positive correlations between MTSM scores, Medical Outcomes Study Short-Form (SF-36), MIDAS, and Migraine Symptom Frequency Bother (MSFB).


RESULTS
In total, 124 participants (mean age 45.4 years, 75% women, 59.7% Caucasian) enrolled. Internal consistency for expectations, importance rankings, outcomes, and satisfaction measures was 0.83, 0.95, 0.86, and 0.95, respectively. As the severity of depression increased, MTSM scores decreased significantly. ANOVA between MTSM scores and symptom bothersomeness and symptom frequency tertiles showed a significant decrease in satisfaction in the moderate-to-severe groups. MTSM scores showed expected associations with MSFB scores (-0.301; P < 0.01), MIDAS (-0.267; P < 0.01), general health (0.253; P < 0.05), mental health (0.217; P < 0.05), and vitality subscales of SF-36 (0.214; P < 0.05). Patients in the HMP reported significantly higher MTSM scores (43.2 vs. 31.4; P < 0.001). Patients on triptans reported a significantly higher satisfaction compared to patients on analgesics (39.5 vs. 32.9; P < 0.05).


CONCLUSIONS
The MTSM is a valid and reliable patient-reported outcome that can be used to evaluate differences in treatment satisfaction associated with migraine therapies.
Martin
Mona L
ML
Health Research Associates, Inc. Mountain Terrace, WA, USA. martin@hrainc.net
Patrick
Donald L
DL
Bushnell
Donald M
DM
Gandra
Shravanthi R
SR
Gilchrist
Kim
K
D000465:Algorithms; D000704:Analysis of Variance; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D017060:Patient Satisfaction / Q000191:economics / Q000706:statistics & numerical data*; D011594:Psychometrics; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome; D014363:Tryptamines / Q000191:economics / Q000627:therapeutic use; D014481:United States
D014363:Tryptamines