Assessment of pain
Open accessAbstract
Unlabelled Valid and reliable assessment of pain is essential for both clinical trials and effective pain management. The nature of pain makes objective measurement impossible. Acute pain can be reliably assessed, both at rest (important for comfort) and during movement (important for function and risk of postoperative complications), with one-dimensional tools such as numeric rating scales or visual analogue scales. Both these are more powerful in detecting changes in pain intensity than a verbal categorical rating scale. In acute pain trials, assessment of baseline pain must ensure sufficient pain intensity for the trial to detect meaningful treatment effects. Chronic pain assessment and its impact on physical, emotional, and social functions require multidimensional qualitative tools and health-related quality of life instruments. Several disease- and patient-specific functional scales are useful, such as the Western Ontario and MacMaster Universities for osteoarthritis, and several neuropathic pain screening tools. The Initiative on Methods Measurement, and Pain Assessment in Clinical Trials recommendations for outcome measurements of chronic pain trials are also useful for routine assessment. Cancer pain assessment is complicated by a number of other bodily and mental symptoms such as fatigue and depression, all affecting quality of life. It is noteworthy that quality of life reported by chronic pain patients can be as much affected as that of terminal cancer patients. Any assessment of pain must take into account other factors, such as cognitive impairment or dementia, and assessment tools validated in the specific patient groups being studied.
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The NRS has good reliability and validity as a measure of pain intensity and is less influenced by present mood state.
“In the context of pain, the NRS has been proven to have good reliability and validity [53,54]. It is a valid measure of pain intensity (0–10) that is less influenced by present mood state [55]”
Telemonitoring with episodic phone calls only partially solves the problems of monitoring because undesired events can occur at different treatment stages, so control calls often occur before or long after unwanted events occur.
“Telemonitoring with episodic phone calls, which is becoming an increasingly common practice, also only partially solves the aforementioned problems. First, because undesired events (e.g., side medication effects or decreased treatment effectiveness) can occur at different treatment stages [34], which means that control calls will often occur before or long after unwanted events occur.”
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- Authors
- Breivik, H., Borchgrevink, P. C., Allen, S. M., Rosseland, L. A., Romundstad, L., Breivik Hals, E. K., Kvarstein, G., & Stubhaug, A.
- Affiliations
- University of Oslo (NO)
- Norwegian University of Science and Technology (NO)
- Corresponding author
- Breivik, H.
- Venue
- British Journal of Anaesthesia
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 101
- Issue
- 1
- Pages
- 17-24
- ISSN
- 0007-0912 (ISSN-L)
- OpenAlex
- W2138261897
- Cited by
- 2,108
- References
- 50
- Citations by year
- 2026: 107 · 2025: 190 · 2024: 163 · 2023: 187 · 2022: 158 · 2021: 174 · 2020: 165 · 2019: 146 · 2018: 127 · 2017: 113 · 2016: 112 · 2015: 118 · 2014: 88 · 2013: 76 · 2012: 53
- FWCI
- 7.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- British Journal of Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- pain assessment, acute pain, chronic pain, cancer pain, health-related quality of life, numerical rating scale, visual analogue scale, functional scales, neuropathic pain screening, cognitive impairment, dementia
- MeSH terms
- Acute Disease, Analgesics, Chronic Disease, Humans, Movement, Neoplasms, Pain, Pain Measurement, Postoperative Pain, Treatment Outcome
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