An opioid screening instrument: long-term evaluation of the utility of the Pain Medication Questionnaire.

ABSTRACT

The Pain Medication Questionnaire (PMQ) was designed to assess the risk for opioid medication misuse in chronic pain patients. A preliminary study showed a positive relationship between higher PMQ scores and concurrent measures of substance abuse, psychopathology, and physical/life-functioning. Using a larger sample size, the present study sought to replicate these findings, and to expand upon them by examining the relationship between PMQ scores and various treatment outcomes. The PMQ was administered to 271 newly evaluated chronic pain patients who were subsequently re-evaluated immediately post-treatment, as well as six months following discharge. Subgroups were then formed according to the lowest (L-PMQ), middle (M-PMQ), and highest (H-PMQ) one-third of PMQ total scores. It was found that the H-PMQ group was 2.6 times more likely to have a known substance-abuse problem, 3.2 times more likely to request early refills of prescription medication, and 2.3 times more likely to drop out of treatment, as compared to the L-PMQ group. They also had diminished biopsychosocial functioning. In addition, at six months following discharge, patients who completed the program experienced a significant decrease in PMQ scores over time relative to those patients who were unsuccessfully discharged from the program or who dropped out. This study represents the second stage in the development of a psychometrically sound screening tool for measuring risk for opioid medication misuse among chronic pain patients, and findings suggest the long-term utility of the PMQ in identifying patients who are more likely to complete and benefit from a pain management program.