Development, Factor Structure, and Preliminary Psychometric Evaluation of the Rhinitis Medicamentosa Questionnaire (
RMQ
) Among Topical Nasal Decongestant Users
Lili Lakatos, Attila Velich, Zsolt Demetrovics, Andrea Czakó, Ildikó Danis, Szabolcs Szentpéteri, József Rácz 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; n = 210) and confirmatory factor analysis (CFA; n = 180) were performed on non‐overlapping subsamples. Internal consistency, preliminary test–retest reliability, and score distribution were assessed.
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.