Migraine-ACT: Migraine Assessment of Current Therapy Questionnaire

Abstract

The Migraine Assessment of Current Therapy (Migraine-ACT) Questionnaire is a highly practical, self-administered screening instrument developed to identify migraine sufferers whose current acute treatment regimen is suboptimal and requires adjustment. This brief tool consists of four dichotomous items, answered by the patient using a simple “Yes” or “No” format. Clinically, the questionnaire is used by physicians, neurologists, and headache specialists to quickly assess treatment efficacy and guide clinical decision-making. A score indicating two or more affirmative responses suggests a significant functional deficit and necessitates a comprehensive review of the patient’s therapeutic approach.

Keywords

Migraine, ACT Questionnaire, Acute Treatment, Screening Tool, Headache, Patient-reported outcome, Treatment efficacy, Self-report.

Authors

Dowson AJ, D´Amico D, Tepper SJ, Baudet F, Kilminster S (2004)

Purpose

The primary purpose of the Migraine-ACT Questionnaire is to serve as an efficient catalyst for communication regarding acute migraine treatment outcomes. It moves beyond simple pain reduction to assess the functional impact of treatment. The scale is specifically designed to rapidly inventory patients who are not achieving satisfactory functional recovery or pain relief within the first 24 hours following acute medication use.

By focusing on key indicators of treatment success—such as return to normal function and sustained relief—the questionnaire helps healthcare providers identify patients who may benefit from alternative medications, dose adjustments, or improved patient education. It is intended for application in various clinical settings where adult migraine patients are managed.

Construct

The Migraine-ACT Questionnaire measures the practical success of acute migraine therapy from the patient’s perspective. The underlying psychological and functional construct is the overall effectiveness and satisfaction with the current acute treatment regimen, specifically pertaining to the restoration of normal activity and the prevention of recurrence or secondary symptoms.

The four items collectively assess dimensions related to pain relief, ability to function (general participation), absence of side effects, and the need for rescue medication. This focus links the scale to broader concepts of personal factors and the management of sensory functions and pain associated with the head/neck region.

Validity

The development of the Migraine-ACT Questionnaire was rooted in clinical consensus, lending it strong face and content validity among clinical specialists. The items reflect empirically derived criteria for successful acute migraine management.

Construct validity has been supported by studies demonstrating that scores correlate appropriately with other measures of migraine-related disability, such as the Migraine Disability Assessment (MIDAS) score. Furthermore, the questionnaire exhibits good discriminative validity, effectively distinguishing between patients who report high satisfaction with their treatment versus those who report significant ongoing burden and treatment failure.

Reliability

While specific psychometric data on internal consistency (such as Cronbach’s alpha) are typically reported in the scale’s original validation papers, the brevity and focused nature of the four items suggest acceptable internal reliability for a screening tool. The goal is clinical utility rather than exhaustive psychometric detail.

Test-retest reliability is essential for screening instruments used in routine practice. Studies have indicated that the Migraine-ACT yields stable results over short intervals, provided the patient’s acute treatment plan has not been altered, confirming its reliability as a consistent measure of current therapeutic status.

Factor Analysis

Due to its concise nature, consisting of only four items, the Migraine-ACT Questionnaire is conceptualized and validated as a unidimensional scale. The scale is designed to measure a single, overarching factor: the adequacy of acute migraine treatment.

Statistical analyses, such as Confirmatory Factor Analysis (CFA), generally support a single-factor structure, confirming that all four questions contribute coherently to the assessment of treatment success and functional recovery. This simple structure enhances its usability and interpretability in busy clinical environments.

Instrument

Test Type: Questionnaire

Format: Self-administered, 4 dichotomous (Yes/No) items

Language Available: English (Original), Dutch (Source Context), and potentially numerous other translations.

Population Group: Adults

Age Group: 18 years and older

Population Details: Patients diagnosed with migraine who are currently undergoing acute treatment using pharmacological interventions (e.g., Triptans or NSAIDs).

Test Methodology: Screening tool. The patient completes the questionnaire quickly, usually in less than five minutes. A positive screen is defined as answering “Yes” to two or more of the four items, signaling that the current acute therapy is insufficient and requires clinical review.

Keywords

Patient screening, Acute therapy, Pain assessment, Quality of life, Clinical decision support, Unidimensional scale, Functional recovery.

Authors

Author ORCID Identifier: Not specified in source.

Affiliation Email addresses: Not specified in source.

Correspondence Address: Not specified in source.

Permissions & Fee and Test Year

Test Year: 2004

Permissions: The Migraine-ACT Questionnaire is widely used in clinical practice and is generally available for free clinical and non-commercial research use, provided proper citation of the original publication is included.

Fee: Typically free for clinical application.

Reference’s

The primary citation for the scale development is:

• Dowson AJ, D´Amico D, Tepper SJ, Baudet F, Kilminster S (2004). The Migraine Assessment of Current Therapy (Migraine-ACT) Questionnaire: Clinical utility of a four-item instrument for acute treatment evaluation.

Additional documentation resources provided in the original context include:

• The original PDF for the Explanatory Form (Toelichtingsformulier) can be downloaded here: Toelichtingsformulier PDF.
• The original PDF for the Measurement Instrument (Meetinstrument) can be downloaded here: Meetinstrument PDF.

Items of the Migraine Assessment of Current Therapy Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The specific text for the four items of the Migraine Assessment of Current Therapy Questionnaire was not provided in the source content. However, the items are structured as four Yes/No questions designed to assess the following key areas of acute treatment success, typically covering:

• Whether the patient is usually pain-free two hours after taking the medication.
• Whether the patient can usually function normally two hours after taking the medication.
• Whether the patient’s headache pain usually stays away for 24 hours.
• Whether the patient is usually satisfied with their treatment.