Predictive model for the Migraine-ACT questionnaire in primary care

Area of Science:

• Neurology
• Clinical Research
• Patient-Reported Outcomes

Background:

• Migraine management is often suboptimal, leading to under-treatment.
• The Migraine Assessment of Current Therapy (Migraine-ACT) is a patient-friendly tool designed to identify individuals who may benefit from adjustments to their acute migraine treatment.

Purpose of the Study:

• To develop and validate a predictive model for the Migraine-ACT questionnaire within a primary care context.
• To assess the questionnaire's utility in identifying patients requiring changes in migraine therapy.

Main Methods:

• A prospective, open-label study involving 3272 patients across 1100 primary care sites.
• Predictive validity was assessed using logistic regression, adjusting for multiple clinical and demographic factors.
• The Migraine-ACT questionnaire's performance was evaluated in predicting treatment changes and patient satisfaction over a 3-month period.

Main Results:

• Treatment was altered for 72% of patients, with overall satisfaction increasing from 15% to 49% after 3 months.
• The predictive model demonstrated 86% sensitivity and 85% specificity in detecting a ≥1-point change in Migraine-ACT scores.
• The model showed 77% sensitivity and 95% specificity in predicting improved patient satisfaction among those with a Migraine-ACT score improvement.

Conclusions:

• The Migraine-ACT questionnaire is a validated, sensitive, and specific tool for predicting treatment outcomes in migraine patients.
• It serves as a valuable instrument for detecting suboptimal migraine management and monitoring treatment efficacy in primary care.
• The questionnaire aids in identifying patients who would benefit from adjustments to their migraine treatment regimen.