What is the Migraine Disability Assessment (MIDAS) questionnaire?

From the Guidelines

The MIDAS Questionnaire is a crucial tool for assessing migraine-related disability and guiding treatment decisions, as it provides a simple and objective measure of functional impairment over a three-month period. The questionnaire consists of five questions that evaluate missed days or reduced productivity in work/school, household work, and social activities due to headaches, with a total score indicating disability level: 0-5 (little/no disability), 6-10 (mild), 11-20 (moderate), and 21+ (severe) 1.

Key Components of the MIDAS Questionnaire

• The questionnaire measures migraine-related disability over a three-month period
• It quantifies missed days or reduced productivity in work/school, household work, and social activities due to headaches
• The total score indicates disability level, which helps guide treatment decisions and monitor treatment effectiveness over time
• The questionnaire also includes two additional questions about headache frequency and pain intensity that provide clinically useful information, although they are not part of the scoring

Clinical Utility of the MIDAS Questionnaire

• Healthcare providers use MIDAS scores to guide treatment decisions and monitor treatment effectiveness over time
• The questionnaire facilitates communication about migraine impact and helps determine appropriate treatment intensity
• Regular use of the MIDAS can help both patients and providers better understand migraine patterns and optimize management strategies, as recommended by primary care physicians as the first point of care for chronic migraine sufferers 1.

Importance of Individualized Care

• The role of as-needed medication overuse in chronic migraine remains unclear, but establishing individualized limits to as-needed and rescue therapy is recommended 1
• Limiting the use of simple analgesics to fewer than 15 days/month and triptans to fewer than 10 days/month is also recommended, taking into account the patient's overall medical profile and avoiding treatments that may exacerbate comorbid conditions 1.

From the Research

Overview of the MIDAS Questionnaire

• The MIDAS Questionnaire is a tool used to assess headache-related disability in patients with migraine and other primary headaches 2, 3.
• It measures the overall impact of headaches over a 3-month period, including lost time due to headache from paid work or school, household work, and nonwork activities 3.
• The questionnaire has been shown to be a useful tool in clinical practice, with high correlation between MIDAS scores and physician judgments regarding patients' pain, disability, and need for medical care 3.

Use of the MIDAS Questionnaire in Different Populations

• The MIDAS Questionnaire has been used in adults and has been shown to be an optimal tool to assess headache-related disability in this population 2.
• It has also been used in children and adolescents with headache, and has been found to be useful in assessing disability in this population, although minimal changes to the phrasing and content of the items may be necessary to make it more specific for younger patients 2.

Relationship Between MIDAS Scores and Migraine Treatment

• There is no direct evidence in the provided studies on the relationship between MIDAS scores and the effectiveness of specific migraine treatments, such as CGRP inhibitors or triptans 4, 5.
• However, the MIDAS Questionnaire may be a useful tool in clinical practice to assess the impact of migraine on patients' daily lives and to monitor the effectiveness of treatment over time 3.