ArticleLaryngoscope investigative otolaryngology2026
Development, Factor Structure, and Preliminary Psychometric Evaluation of the Rhinitis Medicamentosa Questionnaire (RMQ) Among Topical Nasal Decongestant Users.
Article in Laryngoscope investigative otolaryngology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Rhinitis medicamentosa (RM) is associated with prolonged topical nasal decongestant (TND) use and may involve dependency-like behavioral patterns extending beyond nasal obstruction alone. Existing sinonasal patient-reported outcome measures do not specifically assess these behavioral features. This study aimed to develop the Rhinitis Medicamentosa Questionnaire (RMQ) and perform a preliminary psychometric evaluation in individuals reporting TND use. Methods: Instrument development followed Waltz's four-stage framework and was informed by Griffiths' addiction model and DSM-5-TR substance use disorder criteria. An initial 50-item pool underwent face and content evaluation involving patients and a multidisciplinary expert panel, resulting in a 37-item version. A total of 390 Hungarian adults reporting TND use within the previous 12 months completed the online questionnaire. Exploratory factor analysis (EFA; Results: The final RMQ consisted of 16 items across four factors: Overuse, Salience, Tolerance, and Withdrawal. CFA demonstrated good model fit (CFI = 0.975, TLI = 0.970, RMSEA = 0.055). Internal consistency was high across all subscales (Cronbach's α = 0.872-0.944), and preliminary test-retest reliability was favorable (ICC = 0.92). Higher RMQ scores were associated with more frequent and prolonged self-reported TND use. An exploratory sample-derived threshold was identified for higher dependency-related burden within the study population. Conclusion: The RMQ is a newly developed multidimensional questionnaire designed to assess dependency-related behavioral patterns associated with prolonged TND use. This preliminary study supports its internal structure, reliability, and interpretability. Further validation in clinically confirmed RM populations and international settings is required.
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