MFIQ: A Reliable and Valid Measure to Evaluate Migraine Impact

The Migraine Functional Impact Questionnaire (MFIQ), currently used to evaluate the outcomes of migraine interventions in clinical trials, is a reliable measure and can be used in clinical practice for assessments, according to a study published in Headache.

Researchers examined the psychometric properties of MFIQ in a prospective, observational study where 569 adults with migraine completed the MFIQ and additional clinical and patient-reported outcome (PRO) instruments, including the Headache Impact Test, Patient-Reported Outcomes Measurement Information System Physical Function Short Form 10a, Migraine-Specific Quality-of-Life Questionnaire, and Patient Global Rating of Change.

Inclusion criteria were adults with episodic migraine (≥4 and ≤14 migraine headache days per month, in each of 3 months prior to screening) and chronic migraine (≥15 headache days per month, of which ≥8 were migraine days, in each of the 3 months prior to screening).

The study included 2 cohorts. Cohort 1 (followed for 4 weeks) was used to inform item reduction, scoring, and cross-sectional properties (reliability and validity) and included patients who were receiving usual standard of care migraine treatment, either taking a preventive migraine medication or no preventive treatment. Cohort 2 (followed for 16 weeks) was used to examine responsiveness to change and included patients starting a new preventive medication and/or increasing the dose of a current preventive medication.

Four domain scores (physical function, usual activities, social function, and emotional function) and a global item score for impact on usual activities were identified. Higher scores on a 0 to 100 scale represented a greater impact. All scores exhibited high internal consistency (α≥0.89) and moderate test-retest reliability among patients who were stable (intraclass correlation coefficient ≥0.47).

Construct validity was demonstrated by significant correlations (all P <.0001) between MFIQ domain scores, related PRO scores, and the frequency of migraine days and headache days. All domain scores differentiated between subgroups defined based on established levels of clinical severity: number of monthly migraine and headache days, migraine interference levels, and scores on other PRO instruments (P <.05). Improvements in MFIQ scores corresponded with clinical improvement (percent reduction in monthly migraine days), improvement in migraine interference with daily activities, and related improvements in PRO scores (P <.05), demonstrating that the MFIQ was responsive to changes in migraine impact.

Limitations of this study included that participants needed to have at least 4 headaches per month to be included, meaning results cannot be generalized to all adults with migraine.

MFIQ is able to capture the week-to-week variability that is an important aspect of the frequent and episodic nature of migraine and naturally occurring fluctuations in the disease. Therefore, MFIQ scores can be used to assess and track the impact of migraine, evaluate therapeutic targets, identify gaps for intervention, and to enhance communication between patients and healthcare providers. They may also be used to evaluate real-world outcomes of interventions for migraine in research and clinical practice settings.

This study was funded by Amgen Inc. Please refer to the reference for a full list of disclosures.

Reference

Kawata AK, Hareendran A, Shaffer S, et al. Evaluating the psychometric properties of the Migraine Functional Impact Questionnaire (MFIQ) [published online June 5, 2019]. Headache. doi: 10.1111/head.13569