Enhancing pain care with the American Pain Society Patient Outcome Questionnaire for use in the Emergency Department (APS-POQ-RED): validating a patient-reported outcome measure

Abstract

Pain is the most common symptom experienced when presenting to the emergency department (ED). Estimates indicate over half of all patients will present in pain. EDs typically focus on care process measures, such as time to first analgesic medication. Process-based metrics remove the patient from their own experience. Unfortunately, when patient-reported measures of pain care are used in the ED for quality improvement or research, they vary widely and often lack validation. Previous work has demonstrated that a modified version of the American Pain Society Patient Outcome Questionnaire Revised Edition (APS POQ R) may provide an ideal patient-reported outcome measure for the adult ED population. However, previous work has left validation incomplete. In this multi-site, multistage research, we demonstrate the construct, convergent and divergent validity and the internal consistency of a modified version of the APS POQ R in adult patients presenting to two large, inner-city EDs with moderate to severe acute pain. After three stages of psychometric testing in 646 patients, we present a nine-question, three construct patient-reported outcome measure for moderate to severe pain in the adult emergency department, now known as the American Pain Society Patient Outcome Questionnaire Revised for the ED (APS POQ RED).

The use and outcomes of non-pharmacological analgesia in the adult emergency department

“…This cross-sectional study uses data that was collected in a previous study, designed to psycometrically validate a new patient-reported outcome measure for acute pain in the ED (9). It is reported in line with the ‘Strengthening the reporting of observational studies in epidemiology’ (STROBE) checklist (10).…”

“…This study used the ED adaptation of the Revised American Pain Society – Patient Outcome Questionnaire (APS-POQ-RED) to collect information on the types and outcomes of pain management in the ED (8, 9). The APS-POQ-RED also collects information about pain intensity, such as most intense pain experienced in the ED, least pain experienced, and the amount of relief received.…”

“…Evaluating the effectiveness of pain management in the ED has been difficult due to a lack of appropriate tools. The recent adaptation (8) and validation (9) of the Revised American Pain Society – Patient Outcome Questionnaire in the ED setting (APS-POQ-RED) provides the means to assess the usage and effectiveness of pain relief in the ED including non-pharmacological analgesia.…”