Development and validation of a short-form Pain Medication Attitudes Questionnaire (PMAQ-14)

Abstract

Attitudes to pain medication are important aspects of adjustment to chronic pain. They are measured by the 47-item Pain Medication Attitudes Questionnaire (PMAQ). To measure those attitudes more quickly and easily, we developed and evaluated a 14-item PMAQ using data from three separate surveys of people with pain in the general population. In survey 1, participants (n=295) completed the 47-item PMAQ and measures of pain, analgesic use, analgesic dependence and attitudes to self-medication. For each of the seven PMAQ scales, the two items that best preserved the content of the parent scales were identified using correlation and regression. The 2-item and parent scales had very similar relationships with other measures, indicating validity had been maintained. The resulting 14-item PMAQ was then completed by participants in survey 2 (n=241) and survey 3 (n=147), along with the same other measures as in survey 1. Confirmatory factor analysis showed that the 14-item PMAQ retained the 7-factor structure of the 47-item version, and correlations with other measures showed it retained the validity of the 47-item version. The PMAQ scale Need was the most significant independent predictor of analgesic dependence in each of four separate multiple regression analyses. This short form of the PMAQ allows attitudes to pain medications to be measured in a valid and more efficient way.