Concerns about medication and medication use in chronic pain.
This report describes a study of how patients view their pain medications. Two hundred and twenty patients with chronic pain completed a set of 78 items regarding beliefs and concerns about pain medication, a brief measure of medication use, and measures of depression and disability. Item and scale analyses resulted in a 47-item measure, the Pain Medication Attitude Questionnaire (PMAQ), that assesses 7 areas of patient concern: addiction, perceived need, unfavorable scrutiny by others, adverse side effects, tolerance, mistrust in the prescribing doctor, and withdrawal. These seven scales had excellent internal consistency and predictable relations with the measures of medication use, depression, and disability supporting their validity. Correlation analyses highlighted relatively strong associations between concerns about medication and measures of emotional distress and disability, suggesting that these concerns may add significantly to the burden of chronic pain. We suggest that concerns about medication use warrant further study and may deserve clinical attention.


CONCLUSIONS
All medication use by chronic pain sufferers is essentially a pattern of patient behavior over time. As such, it appears to be multiply-determined, by beliefs, emotions, bodily sensations, and the social, cultural, and personal learning history that give these experiences their meaning and functions.
McCracken
Lance M
LM
Pain Management Unit, Royal National Hospital for Rheumatic Diseases & University of Bath, Bath, United Kingdom. Lance.McCracken@RNHRD-tr.swest.nhs.uk
Hoskins
Julian
J
Eccleston
Christopher
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001294:Attitude to Health; D002908:Chronic Disease / Q000188:drug therapy / Q000523:psychology; D003469:Culture; D004185:Disability Evaluation; D004361:Drug Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010148:Intractable Pain / Q000188:drug therapy* / Q000523:psychology*; D010817:Physician-Patient Relations; D012919:Social Behavior; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control / Q000523:psychology; D019966:Substance-Related Disorders / Q000517:prevention & control / Q000523:psychology; D011795:Surveys and Questionnaires / Q000592:standards*
D000700:Analgesics