MTOQ-5 Migraine Treatment Optimization Questionnaire (acute therapy)
 
Name: Date:
 
1. After taking your medication, are you pain free within 2 hours of most attacks?
 
    Never       Less than half the time         Half the time or more
 
 
2. Does one dose of medication relieve your headache and keep it away for at least 24 hours?
 
    Never       Less than half the time         Half the time or more
 
 
3. Are you able to return quickly to your normal activities (i.e. work, family, leisure, social activities) after taking your migraine medication?
 
    Never       Less than half the time         Half the time or more
 
 
4. Is your migraine medication well tolerated?
 
    Never       Less than half the time         Half the time or more
 
 
5. Are you comfortable enough with your medication to be able to plan daily activities?
 
    Never       Less than half the time         Half the time or more
 
This is a validated tool to use patient-reported outcomes to identify:
• Identify patients with an inadequate treatment response
• Identify patients who require a change of their current acute treatment
Suggested treatment optimization strategies: https://www.researchgate.net/publication/24037278_Validity_and_Reliability_of_the_Migraine-Treatment_Optimization_Questionnaire
1. After taking your medication, are you pain free within 2 hours of most attacks? (Consistency)
a. Treat earlier
b. Switch to a drug with evidence of higher consistency of response (e.g. rizatriptan)
2. Does one dose of medication relieve your headache and keep it away for at least 24 hours? (Recurrence)
a. Treat earlier
b. Increase dose
c. Consider a drug with a low recurrence rate or a high 24-h headache response (e.g. eletriptan, frovatriptan)
3. Are you able to return quickly to your normal activities (i.e. work, family, leisure, social activities) after taking your migraine medication? (Functional response)
a. Treat earlier
b. Increase dose
c. Switch to medications with greater efficacy (e.g. eletriptan or rizatriptan)
d. Combine medications from different classes (e.g. triptan and NSAID, triptan and metoclopramide)
4. Is your migraine medication well tolerated? (Side effects)
a. Treat earlier
b. Reduce dose
c. Consider use of a drug with a more favourable tolerability profile (e.g. almotriptan, naratriptan)
5. Are you comfortable enough with your migraine medication to be able to plan your daily activities? (Global)
a. If patient is satisfied with all four of the above but not overall: discuss expectations and consider behavioural or preventive treatment
Subject:
Creative Commons License created April 25th 2021 by Dr. John Robertson, licensed under a GPL.
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