Robinson-Papp Jessica, George Mary Catherine, Wongmek Arada, Nmashie Alexandra, Merlin Jessica S, Ali Yousaf, Epstein Lawrence, Green Mark, Serban Stelian, Sheth Parag, Simpson David M
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
J Pain Symptom Manage. 2015 Sep;50(3):381-6. doi: 10.1016/j.jpainsymman.2015.03.013. Epub 2015 Apr 23.
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.
The aim of this study was to describe the development and preliminary validation of the QAQ.
The QAQ was studied in a convenience sample of 149 HIV-infected participants.
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.
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.
患者按医嘱服用慢性疼痛药物的程度尚未得到充分研究，且没有普遍认可的衡量方法。定量镇痛问卷（QAQ）是一种新工具，旨在全面记录患者报告的药物使用情况，生成分数以对其进行量化（按个体药物、类别和/或总体），并将其与规定的治疗方案进行（定性和/或定量）比较。
本研究的目的是描述QAQ的开发和初步验证。
在149名感染HIV的参与者的便利样本中对QAQ进行了研究。
我们发现，根据参与者慢性疼痛药物治疗方案计算出的QAQ分数是有效的，这基于它们与以下两项的相关性：1）患者报告的疼痛强度（r = 0.38；P < 0.001）和2）经验丰富的疼痛管理医生对治疗方案的独立量化（r = 0.89；P < 0.001）。QAQ还显示出较高的评分者间信度（r = 0.957；P < 0.001）。对34名参与者的子集进行的QAQ数据详细检查表明，QAQ显示44%的参与者依从性欠佳，并且包含了94%仅通过病历审查无法获得的信息，包括非处方药物的使用和“按需”给药的量化。还发现QAQ有助于量化药物治疗方案随时间的变化，在从基线到八周随访期间，50%的参与者出现了变化。
QAQ是一种简单的工具，可以促进对患者报告的慢性疼痛药物治疗方案的理解，包括计算依从百分比和生成适合估计和跟踪药物使用随时间变化的定量分数。
