Rheumatologists update assessments for adult pain

Assessment of patient outcomes allows physicians and researchers to measure the success or failure of diagnostics and treatments that patients receive. One set of measurement tools focuses on assessing adult pain and is included in a special issue of Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), providing physicians and researchers with a single resource of 250 patient outcomes measurements in rheumatology.

The World Health Organization (WHO) indicates that more than 150 rheumatic or musculoskeletal diseases can contribute to pain and disability in adults. Rheumatoid arthritis is a painful, autoimmune disease which causes inflammation in the joints and is estimated to affect up to 1% of the global population. Osteoarthritis is caused by failed repair of injury from various joint stresses, resulting in total joint breakdown. Osteoarthritis—which causes pain, stiffness and reduced movement of affected joints, such as knees, hips, fingers and lower spine, leading to disability—affects close to 10% of men and 18% of women over age 60, worldwide, according to WHO reports.

"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," explains Dr. Gillian Hawker, a rheumatologist and clinical epidemiologist at the University of Toronto in Canada. "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." Details regarding questionnaire content, ease of use, and measurement properties are included in the review of each questionnaire.

The authors present a review of generic uni- and multi-dimensional pain assessment tools including the Visual Analog Scale, Numeric Rating Scale, Short-form McGill Pain Questionnaire, Chronic Pain Grade Scale, Short Form-36 Bodily Pain Scale, and the Measure of Intermittent and Constant Osteoarthritis Pain. The latter is a relatively new osteoarthritis-specific pain questionnaire designed to evaluate pain patterns and impact that is distinct from the impact of pain on physical function. A discussion of the strengths and weakness of each questionnaire is also provided.

Along with Dr. Hawker's review of "Measures in Adult Pain," assessment tools to measure patient outcomes in areas such as sleep, fatigue, physical function, and depression are also available in this special issue. Dr. Patricia Katz with the University of California and Guest Editor of the Arthritis Care & Research special issue, "Patient Outcomes in Rheumatology, 2011" 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."