Jessica Robinson-Papp1, Mary Catherine George2, Arada Wongmek2, Alexandra Nmashie2, Jessica S Merlin3, Yousaf Ali4, Lawrence Epstein5, Mark Green2, Stelian Serban5, Parag Sheth6, David M Simpson2. 1. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: jessica.robinson-papp@mssm.edu. 2. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 3. Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 4. Department of Rheumatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 5. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 6. Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
CONTEXT: 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. OBJECTIVES: 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. CONCLUSION: 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.
CONTEXT: 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. OBJECTIVES: 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-infectedparticipants. 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. CONCLUSION: 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.
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