Evaluation of the Preliminary Validity of Misuse of Prescription Pain Medication Items from the Patient-Reported Outcomes Measurement Information System (PROMIS)®

Pain Med. 2019 Oct 1;20(10):1925-1933. doi: 10.1093/pm/pnz001.


Objective: The National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS)® includes an item bank for measuring misuse of prescription pain medication (PROMIS-Rx Misuse). The bank was developed and its validity evaluated in samples of community-dwelling adults and patients in addiction treatment programs. The goal of the current study was to investigate the validity of the item bank among patients with mixed-etiology chronic pain conditions.

Method: A consecutive sample of 288 patients who presented for initial medical evaluations at a tertiary pain clinic completed questionnaires using the open-source Collaborative Health Outcomes Information Registry. Participants were predominantly middle-aged (M [SD] = 51.6 [15.5] years), female (62.2%), and white/non-Hispanic (51.7%). Validity was evaluated by estimating the association between PROMIS-Rx Misuse scores and scores on other measures and testing the ability of scores to distinguish among risk factor subgroups expected to have different levels of prescription pain medicine misuse (known groups analyses).

Results: Overall, score associations with other measures were as expected and scores effectively distinguished among patients with and without relevant risk factors.

Conclusion: The study results supported the preliminary validity of PROMIS-Rx Misuse item bank scores for the assessment of prescription opioid misuse in patients visiting an outpatient pain clinic.

Keywords: Assessment; Item Response Theory; Misuse of Prescription Opioid; PROMIS; Prescription Pain Medication.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care Facilities
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Female
  • Humans
  • Information Systems*
  • Male
  • Middle Aged
  • Pain / drug therapy
  • Pain Measurement
  • Patient Reported Outcome Measures*
  • Prescription Drug Misuse*
  • Reproducibility of Results
  • Risk Factors
  • Surveys and Questionnaires
  • Treatment Outcome


  • Analgesics, Opioid