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The Migraine Disability Assessment (MIDAS) Questionnaire in the Primary-Care Setting

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Abstract

Migraine is a remarkably disabling condition, although unpredictable and heterogeneous in frequency, duration and severity. It can be difficult to manage in primary care where it is under-recognised, underdiagnosed and undertreated. Proposals have been made that migraine care could be improved by incorporating assessments of migraine impact into management strategies, and measuring headache-related disability can be used to assess the impact of migraine on people’s lives and society. The Migraine Disability Assessment (MIDAS) questionnaire was developed from this research. MIDAS is a scientifically reliable and valid measure of migraine disability that can improve communication between patients and physicians, assess migraine severity and act as an outcome measure to monitor treatment efficacy. Perhaps the most important use of MIDAS is as an aid to public health initiatives on headache. MIDAS can be used to screen populations for headache-related disabilities and medical needs and be part of generalised migraine management guidelines in primary care in order to produce an individualised treatment plan for each patient. MIDAS can be used by physicians, pharmacists, nurses and patients.

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References

  1. Breslau N, Rasmussen BK. The impact of migraine: epidemiology, risk factors, and co-morbidities. Neurology 2001; 56 Suppl. 1: 4–12

    Article  Google Scholar 

  2. Osterhaus JT, Townsend RJ, Gandek B, et al. Measuring the functional status and well-being of patients with migraine headache. Headache 1994; 34: 337–43

    Article  PubMed  CAS  Google Scholar 

  3. Ferrari MD. The economic burden of migraine to society. Pharmacoeconomics 1998; 13: 667–76

    Article  PubMed  CAS  Google Scholar 

  4. Lipton RB, Goadsby PJ, Sawyer JPC, et al. Migraine: diagnosis and assessment of disability. Rev Contemp Pharmacother 2000; 11: 63–73

    Google Scholar 

  5. Silberstein SD, Lipton RB. Chronic daily headache. Curr Opin Neurol 2000; 13: 277–83

    Article  PubMed  CAS  Google Scholar 

  6. Dowson AJ. Analysis of the patients attending a specialist UK headache clinic over a 3-year period. Headache 2003; 43: 14–8

    Article  PubMed  Google Scholar 

  7. Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American migraine study II. Headache 2002; 41: 646–57

    Article  Google Scholar 

  8. Lipton RB, Diamond S, Reed M, et al. Migraine diagnosis and treatment: results from the American migraine study II. Headache 2001; 41: 638–45

    Article  PubMed  CAS  Google Scholar 

  9. Silberstein SD, for the US Headache Consortium. Practice parameter: evidencebased guidelines for migraine headache (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2000; 55: 754–62

    Article  PubMed  CAS  Google Scholar 

  10. Bedell AW, Cady RK, Diamond ML, et al. Patient-centered strategies for effective management of migraine. Springfield: Primary Care Network, 2000

    Google Scholar 

  11. Dowson AJ, Lipscombe S, Sender J, et al. New guidelines for the management of migraine in primary care. Curr Med Res Opin 2002; 18: 414–39

    Article  PubMed  CAS  Google Scholar 

  12. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders. Cephalalgia 2004; 24 Suppl. 1: 1–160

    Google Scholar 

  13. National Academy of Sciences/Institute of Medicine (NAS/IOM). Disability in America: toward a national agenda for prevention. Washington, DC: NAS Press, 1991

    Google Scholar 

  14. Stewart WF, Shechter A, Lipton RB. Migraine heterogeneity: disability, pain intensity, and attack frequency and duration. Neurology 1994; 44 Suppl. 4: S24–39

    Google Scholar 

  15. Edmeads J, Findlay H, Tugwell P, et al. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci 1993; 20: 131–7

    PubMed  CAS  Google Scholar 

  16. Sakai F, Igarashi H. Epidemiology of migraine in Japan. Cephalalgia 1997; 17: 15–22

    Article  PubMed  CAS  Google Scholar 

  17. Clarke CE, MacMillan L, Sondhi S, et al. Economic and social impact of migraine. Q J Med 1996; 89: 77–84

    Article  CAS  Google Scholar 

  18. Dowson A, Jagger S. The UK migraine patient survey: quality of life and treatment. Curr Med Res Opin 1999; 15: 241–53

    Article  PubMed  CAS  Google Scholar 

  19. Von Korff M, Stewart WF, Simon DJ, et al. Migraine and reduced work performance: a population-based diary study. Neurology 1998; 50: 1741–5

    Article  Google Scholar 

  20. Abu-Arefeh I, Russell G. Prevalence of headache and migraine in schoolchildren. BMJ 1994; 309: 765–9

    Article  PubMed  CAS  Google Scholar 

  21. Osterhaus J. The hidden consequences of migraine. In: Edmeads J, editor. Migraine: a brighter future. Worthing: Cambridge Medical Publications, 1993; 21–7

    Google Scholar 

  22. Office of Health Economics. Compendium of health statistics. London: OHE, 1989

    Google Scholar 

  23. Smith R. Impact of migraine on the family. Headache 1998; 38: 423–6

    Article  PubMed  CAS  Google Scholar 

  24. Kryst S, Scherl ER. Social and personal impact of headache in Kentucky. In: Olesen J, editor. Headache classification and epidemiology. New York: Raven Press Ltd, 1994; 345–50

    Google Scholar 

  25. Liddell J. Migraine: the patient’s perspective. Rev Contemp Pharmacother 1994; 5: 253–7

    Google Scholar 

  26. de Lissovoy G, Lazarus SS. The economic cost of migraine: present state of knowledge. Neurology 1994; 44 Suppl. 4: 56–62

    Google Scholar 

  27. Holmes WF, MacGregor EA, Sawyer JPC, et al. Information about migraine disability influences physicians’ perceptions of illness severity and treatment needs. Headache 2001; 41: 343–50

    Article  PubMed  CAS  Google Scholar 

  28. Von Korff M, Ormel J, Keefe FJ, et al. Grading the severity of chronic pain. Pain 1992; 50: 133–49

    Article  Google Scholar 

  29. Von Korff MR, Stang PE. Prediction of the psychosocial and behavioral outcomes of headache. In: Olesen J, editor. Headache classification and epidemiology. New York: Raven Press Ltd, 1994, 367–71

    Google Scholar 

  30. Stewart WF, Lipton RB, Simon D, et al. Reliability of an illness severity measure for headache in a population sample of migraine sufferers. Cephalalgia 1998; 18: 44–51

    Article  PubMed  CAS  Google Scholar 

  31. Stewart WF, Lipton RB, Simon D, et al. Validity of an illness severity measure in a population sample of migraine headache sufferers. Pain 1999; 79: 291–301

    Article  PubMed  CAS  Google Scholar 

  32. Stewart WF, Lipton RB, Kolodner K, et al. Reliability of the Migraine Disability Assessment score in a population-based sample of headache sufferers. Cephalalgia 1999; 19: 107–14

    Article  PubMed  CAS  Google Scholar 

  33. Stewart WF, Lipton RB, Whyte J, et al. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology 1999; 53: 988–94

    Article  PubMed  CAS  Google Scholar 

  34. Stewart WF, Lipton RB, Kolodner KB, et al. Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 2000; 88: 41–52

    Article  PubMed  CAS  Google Scholar 

  35. Lipton RB, Stewart WF, Sawyer J, et al. Clinical utility of an instrument assessing migraine disability: the Migraine Disability Assessment (MIDAS) questionnaire. Headache 2001; 41: 854–61

    PubMed  CAS  Google Scholar 

  36. Stewart WF, Lipton RB, Kolodner K. Migraine Disability Assessment (MIDAS) score: relation to headache frequency, pain intensity, and headache symptoms. Headache 2003; 43: 258–65

    Article  PubMed  Google Scholar 

  37. D’Amico D, Grazzi L, Usai S, et al. Use of the Migraine Disability Assessment questionnaire in children and adolescents with headache: an Italian pilot study. Headache 2003; 43: 767–73

    Article  PubMed  Google Scholar 

  38. Hershey AD, Powers SW, Vockell AL, et al. PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology 2001; 57: 2034–9

    Article  PubMed  CAS  Google Scholar 

  39. D’Amico D, Mosconi P, Genco S, et al. The Migraine Disability Assessment (MIDAS) questionnaire: translation and reliability of the Italian version. Cephalalgia 2001; 21: 947–52

    Article  PubMed  Google Scholar 

  40. Iigaya M, Sakai F, Kolodner KB, et al. Reliability and validity of the Japanese Migraine Disability Assessment (MIDAS) questionnaire. Headache 2003; 43: 343–52

    Article  PubMed  Google Scholar 

  41. Stewart W, Lipton R. Need for care and perceptions of MIDAS among headache sufferers study. CNS Drugs 2002; 16 Suppl. 1: 5–11

    Article  PubMed  Google Scholar 

  42. Edmeads J, Láinez JM, Brandes JL, et al. Potential of the Migraine Disability Assessment (MIDAS) questionnaire as a public health initiative and in clinical practice. Neurology 2001; 56 Suppl. 1: S29–34

    Article  Google Scholar 

  43. Parra J, Láinez MJA, Monzón MJ, et al. Differences in attitude between primary care physician and neurologist in migraine patient [abstract]. Cephalalgia 1999; 19: 340

    Google Scholar 

  44. Lipton RB, Holmes WF, Sawyer JP, et al. Measuring the impact migraine has on the patient can help to determine an appropriate treatment strategy: physicians’ assessment. Headache Care 2004; 1: 39–42

    Article  Google Scholar 

  45. Lipton RB. Disability assessment as a basis for stratified care. Cephalalgia 1998; 18 Suppl. 22: 40–6

    PubMed  Google Scholar 

  46. Lipton RB, Stewart WF, Stone AM, et al. Stratified care vs step care strategies for migraine: results of the Disability in Strategies of Care (DISC) Study. JAMA 2000; 284: 2599–605

    Article  PubMed  CAS  Google Scholar 

  47. Sculpher M, Millson D, Meddis D, et al. Cost-effectiveness of stratified versus stepped care strategies for acute treatment of migraine: the Disability In Strategies for Care (DISC) study. Pharmacoeconomics 2002; 20: 91–100

    Article  PubMed  Google Scholar 

  48. Lipton RB, Cady RK, Stewart WF, et al. Diagnostic lessons from the Spectrum study. Neurology 2002; 58 (9 Suppl. 6): S27–31

    Article  Google Scholar 

  49. Tepper SJ, Dahlöf CGH, Dowson A, et al. Prevalence and diagnosis of migraine in patients consulting their physician with a complaint of headache: data from the Landmark Study. Headache 2004; 44: 856–64

    Article  PubMed  Google Scholar 

  50. Pilgrim AJ. Methodology of clinical trials of sumatriptan in migraine and cluster headache. Eur J Neurol 1991; 31: 295–9

    Article  CAS  Google Scholar 

  51. Oral sumatriptan and aspirin-plus-metoclopramide comparative study group. A study to compare oral sumatriptan with oral aspirin plus oral metoclopramide in the acute treatment of migraine. Eur J Neurol 1992; 32: 177–84

    Article  Google Scholar 

  52. Tfelt-Hansen P, Henry P, Mulder LJ, et al. The effectiveness of combined oral lysine acetylsalicylate and metoclopramide compared with oral sumatriptan for migraine. Lancet 1995; 346: 923–6

    Article  PubMed  CAS  Google Scholar 

  53. International Headache Society Clinical Trials Subcommittee. Guidelines for controlled trials of drugs in migraine: second edition. Cephalalgia 2000; 20: 765–86

    Article  Google Scholar 

  54. Otsuka N, Sakai F, Iigaya M, et al. MIDAS assessments of migraine management, including the use of triptans, in Japan. Headache Care 2004; 1: 115–21

    Article  Google Scholar 

  55. Mathew NT, Kailasam J, Meadors L. Prophylaxis of migraine, transformed migraine, and cluster headache with topiramate. Headache 2002; 42: 796–803

    Article  PubMed  Google Scholar 

  56. Main A, Abu-Saad H, Salt R, et al. Management by nurses of primary headache; a pilot study. Curr Med Res Opin 2002; 18: 471–8

    Article  PubMed  CAS  Google Scholar 

  57. Dowson AJ, Salt R. The outcome of headache management following nurse intervention: assessment in clinical practice using the MIDAS questionnaire. Headache Care 2004; 1: 177–81

    Article  Google Scholar 

  58. Queiroz LP, Barea LM, Blank N. A population-based study of headache-related disability in Florianopolis, Brazil [abstract]. Cephalalgia 2001; 21: 329

    Google Scholar 

  59. Boardman HF, Millson DS, Croft PR, et al. Health care consultations and disability due to headache [abstract]. Cephalalgia 2001; 21: 330–1

    Google Scholar 

  60. Brandes JL. Global trends in migraine care: results from the MAZE survey. CNS Drugs 2002; 16 Suppl. 1: 13–8

    Article  PubMed  Google Scholar 

  61. MacGregor EA, Brandes J, Eikermann A. Migraine prevalence and treatment patterns: the global migraine and zolmitriptan evaluation survey. Headache 2003; 43: 19–26

    Article  PubMed  Google Scholar 

  62. Main A, Vlachonikos I, Dowson A. Headache characteristics of a sample of student nurses entering university [poster]. Headache World 2000; 2000 Sep 3-8; London

    Google Scholar 

  63. D’Amico D, Usai S, Grazzi L, et al. Quality of life and disability in primary chronic daily headaches. J Neurol Sci 2003; 24 Suppl. 2: S97–100

    Google Scholar 

  64. Bigal ME, Rapoport AM, Lipton RB, et al. Assessment of migraine disability using the Migraine Disability Assessment (MIDAS) questionnaire: a comparison of chronic migraine with episodic migraine. Headache 2003; 43: 336–42

    Article  PubMed  Google Scholar 

  65. Brandes JL, Roberson SC. Impact of co-morbid depression on migraine disability in clinical practice: preliminary observations. Presented at the 56th Annual Meeting of the American Academy of Neurology; 2004 Apr 24-May 1; San Francisco

    Google Scholar 

  66. Leon-Sarmiento FE, Martinez M, Garcia I, et al. Migraine and MIDAS (MIDASELA) in Colombian hospital workers [in Spanish]. Rev Neurol 2003; 36: 412–7

    PubMed  CAS  Google Scholar 

  67. Diamond M, Cady R, Dewey J, et al. The internet-delivered dynamic headache impact test (HIT?): profile of the first 19 000+ respondents [abstract]. Cephalalgia 2001; 21: 332

    Google Scholar 

  68. Kosinski M, Bayliss MS, Bjorner JB, et al. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res 2003; 12: 963–74

    Article  PubMed  CAS  Google Scholar 

  69. Dowson A, Diamond M, Pryse-Phillips W, et al. Health care-seeking behaviour of respondents after taking the headache impact test (HITℳ [abstract]. Cephalalgia 2001; 21: 332–3

    Google Scholar 

  70. Garber WH, Kosinski M, Dahlof C, et al. HIT-6 reliably measures the impact of headache [abstract]. Cephalalgia 2001; 21: 333

    Google Scholar 

  71. Ware J, Kosinski M, Dahlof C, et al. Validity of HIT-6, a paper-based short form for measuring headache impact [abstract]. Cephalalgia 2001; 21: 333

    Google Scholar 

  72. Bayliss MS, Kosinski M, Diamond M, et al. HIT-6 scores discriminate among headache sufferers differing in headache-associated workplace productivity loss [abstract]. Cephalalgia 2001; 21: 333–4

    Google Scholar 

  73. Kilminster SG, Dowson A, Bundy M. The Headache Impact Test® and the Short Pain Inventory©: outcome measures compared. Int J Pharm Med 2003; 17: 23–32

    Google Scholar 

  74. Kilminster SG. Manual for the short pain inventory. West Sussex: Lawrencian Clinical Publications and Selsey Press Ltd, 1998

    Google Scholar 

  75. Ware JE, Bjorner JB, Kosinski M. Practical implications of item response theory and computerized adaptive testing. Med Care 2000; 38: S73–82

    Article  Google Scholar 

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Acknowledgements

The MIDAS questionnaire was developed by Professor Richard Lipton and Dr Walter Stewart of Innovative Medical Research Inc., with sponsorship and assistance from AstraZeneca. The authors have all received grants from AstraZeneca to pursue research on the MIDAS questionnaire but received no payments for the writing of this article.

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Authors and Affiliations

  1. The King’s Headache Service, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    Andrew J. Dowson

  2. The Third Department of Internal Medicine (Neurology), Kitasato University School of Medicine, Kanagawa, Japan

    Fumihiko Sakai

  3. Vanderbilt University School of Medicine, Nashville, Tennessee, USA

    Jan Brandes

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  1. Andrew J. Dowson
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  2. Fumihiko Sakai
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  3. Jan Brandes
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Correspondence to Andrew J. Dowson.

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Dowson, A.J., Sakai, F. & Brandes, J. The Migraine Disability Assessment (MIDAS) Questionnaire in the Primary-Care Setting. International Journal of Pharmaceutical Medicine 18, 325–335 (2004). https://doi.org/10.2165/00124363-200418060-00002

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