Clinician's Guide to the Best Adult Pain Measures

Janis C. Kelly

November 28, 2011

November 28, 2011 — A special issue of Arthritis Care & Research, "Patient Outcomes in Rheumatology, 2011," published online November 7, includes a new guide for measuring pain in adult patients. The special issue provides clinicians and researchers with a unique resource for evaluating pain, sleep, fatigue, physical function, and depression.

"Pain is the most significant complaint of patients with rheumatic conditions. Thus, assessment of pain, including its intensity, frequency and impact on the patient’s physical function, sleep, mood and overall quality of life is integral to good care," said Gillian Hawker, MD, lead author for the pain section, in a press statement.

Dr. Hawker, who is a rheumatologist and clinical epidemiologist at the University of Toronto, Ontario, Canada, added, "Our overview of available pain questionnaires provides both clinicians and researchers with a quick reference for comparing and selecting the most appropriate assessment tool for their purpose."

The review includes the Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Details on questionnaire content, ease of use, and measurement properties are included in the review of each questionnaire. The review also discusses the strengths and weakness of each questionnaire.

For clinicians, the reviewers recommend the NRS Pain for estimating patients' pain intensity and the SF-36 BPS for evaluating pain in the context of overall health status. Both are seen as easy to administer and simple enough to use at the point of care.

They also recommend the ICOAP for assessment of osteoarthritis-related pain. "[The ICOAP] is an osteoarthritis-specific pain measure that is recommended for descriptive and evaluative purposes in both clinical practice and research to provide a comprehensive evaluation of the pain experience in osteoarthritis, including the impact of pain on mood, sleep and quality of life separate and distinct from the impact of pain on functioning," the authors write. The other tests for osteoarthritis pain are seen as mainly research tools.

Patricia Katz, MD, from the University of California and guest editor of the Arthritis Care & Research special issue, said, "In this issue, we update and expand the number of patient outcomes measures originally published in 2003 to include more than 250 measures — twice as many as previously covered. This single-source reference provides rheumatologists and researchers with a valuable, up-to-date resource for evaluating current patient assessment tools."

Dr. Hawker has disclosed no relevant financial relationships.

Arthritis Care Res. 2011;63:S240-S252. Abstract


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