HRONIC NONCANCER PAIN IS associated with considerable physical and psychosocial impairment, distress, comorbid depression, and increased health care use and costs. [1][2][3][4] Many primary care patients report chronic pain, 2,5,6 most commonly musculoskeletal pain. 2,7 Guidelines for chronic pain treatment have been developed. 8,9 However, implementation has been problematic, especially in busy primary care practices in which access to recommended treatment components may be limited.Multifaceted, collaborative interventions can promote guideline-concordant care and improve outcomes for chronic conditions in primary care. 10,11 These interventions, based on the chronic care model, 10 attempt to optimize patient and clinician interactions via education and activation while providing system support, including care management and clinician feedback. Several investigators have demonstrated improvements in pain intensity and pain-related function in studies of interventions using collaborative approaches. 12-14 However, one of these studies used a pre-post design, 14 and the

The CGIC-PF is a structured assessment of change in physical frailty with defined content and process. It has strong face validity, reliability, and feasibility for use in clinical research. It may be useful as one criterion of change and as an anchor for change in other measures.