Introduction of a Self-Report Version of the Prescription Drug Use Questionnaire and Relationship to Medication Agreement Noncompliance

Compton, Peggy A.; Wu, Stephen M.; Schieffer, Beatrix; Pham, Quynh; Naliboff, Bruce D.

doi:10.1016/j.jpainsymman.2007.11.006

« Previous Next »Journal of Pain and Symptom Management
Volume 36, Issue 4 , Pages 383-395, October 2008

Introduction of a Self-Report Version of the Prescription Drug Use Questionnaire and Relationship to Medication Agreement Noncompliance

Peggy A. Compton, RN, PhD
- Acute Care Section, School of Nursing at UCLA, Los Angeles, California, USA
- Address correspondence to: Peggy Compton, RN, PhD, School of Nursing, University of California at Los Angeles, Factor Building 4-246, Box 956918, Los Angeles, CA 90095-6918, USA.
Stephen M. Wu, PhD
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
- UCLA Center for Neurovisceral Sciences and Women's Health, Los Angeles, California, USA
Beatrix Schieffer, PhD
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
- UCLA Center for Neurovisceral Sciences and Women's Health, Los Angeles, California, USA
Quynh Pham, MD
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
Bruce D. Naliboff, PhD
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
- UCLA Center for Neurovisceral Sciences and Women's Health, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA

Accepted 6 November 2007. published online 30 May 2008.

Abstract

The Prescription Drug Use Questionnaire (PDUQ) is one of several published tools developed to help clinicians better identify the presence of opioid abuse or dependence in patients with chronic pain. This paper introduces a patient version of the PDUQ (PDUQp), a 31-item questionnaire derived from the items of the original tool designed for self-administration, and describes evidence for its validity and reliability in a sample of patients with chronic nonmalignant pain and on opioid therapy. Further, this study examines instances of discontinuation from opioid medication treatment related to violation of the medication agreement in this population, and the relationship of these with problematic opioid misuse behaviors, PDUQ and PDUQp scores. A sample of 135 consecutive patients with chronic nonmalignant pain was recruited from a multidisciplinary Veterans Affairs chronic pain clinic, and prospectively followed over one year of opioid therapy. Using the PDUQ as a criterion measure, moderate to good concurrent and predictive validity data for the PDUQp are presented, as well as item-by-item comparison of the two formats. Reliability data indicate moderate test stability over time. Of those patients whose opioid treatment was discontinued due to medication agreement violation-related discontinuation (MAVRD) (n=38 or 28% of sample), 40% of these (n=11) were due to specific problematic opioid misuse behaviors. Based upon specificity and sensitivity analyses, a suggested cutoff PDUQp score for predicting MAVRD is provided. This study supports the PDUQp as a useful tool for assessing and predicting problematic opioid medication use in a chronic pain patient sample.