The Quantitative Analgesic Questionnaire: A Tool to Capture Patient-Reported Chronic Pain Medication Use.
BACKGROUND
The extent to which patients take chronic pain medications as prescribed is not well studied, and there are no generally agreed-upon measures. The Quantitative Analgesic Questionnaire (QAQ) is a new instrument designed to comprehensively document patient-reported medication use, generate scores to quantify it (by individual drug, class, and/or overall), and compare it (qualitatively and/or quantitatively) to the regimen as prescribed.


OBJECTIVE
The aim of this study was to describe the development and preliminary validation of the QAQ.


METHODS
The QAQ was studied in a convenience sample of 149 HIV-infected participants.


RESULTS
We found that the QAQ scores computed for participants' chronic pain medication regimens were valid based on their correlation with 1) patient-reported pain intensity (r = 0.38; P < 0.001) and 2) experienced pain management physicians' independent quantification of the regimens (r = 0.89; P < 0.001). The QAQ also demonstrated high interrater reliability (r = 0.957; P < 0.001). Detailed examination of the QAQ data in a subset of 34 participants demonstrated that the QAQ revealed suboptimal adherence in 44% of participants and contained information that would not have been gleaned from review of the medical record alone in 94%, including use of over-the-counter medications and quantification of "as needed" dosing. The QAQ also was found to be useful in quantifying change in the medication regimen over time, capturing a change in 50% of the participants from baseline to eight week follow-up.


CONCLUSIONS
The QAQ is a simple tool that can facilitate understanding of patient-reported chronic pain medication regimens, including calculation of percent adherence and generation of quantitative scores suitable for estimating and tracking change in medication use over time.
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: jessica.robinson-papp@mssm.edu.
Jessica
J
Robinson-Papp
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Mary Catherine
MC
George
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Arada
A
Wongmek
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Alexandra
A
Nmashie
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Jessica S
JS
Merlin
Department of Rheumatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Yousaf
Y
Ali
Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Lawrence
L
Epstein
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Mark
M
Green
Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Stelian
S
Serban
Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Parag
P
Sheth
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
David M
DM
Simpson
D000700:Analgesics / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015203:Reproducibility of Results; D057566:Self Report
D000700:Analgesics
Chronic pain; medication adherence; quantitative measures