Primary care assessment instruments for patients at risk of, or with, persistent pain: opportunistic findings from a systematic literature review

Abstract

BackgroundEarly identification in primary care settings of individuals with, or at-risk of, developing persistent pain, is important to limit development of disability. There is little information to assist primary care providers to choose or deliver relevant, efficient, and soundly constructed assessment instruments for this purpose.ObjectiveWe recently published the findings of a literature review, which produced a compendium of assessment instruments to identify adults with, or at-risk of developing, persistent pain of noncancer origin. This paper reports on instruments opportunistically identified during this review which may be appropriate to primary health care settings for early identification of such patients.ResultsOne hundred sixteen potentially useful instruments were initially identified in the review, measuring pain severity, psychological distress, functional capacity, quality of life or multidimensional constructs of persistent pain. Following a series of steps, 45 instruments were shortlisted, with sound clinical utility and strong psychometric properties. Of these, 16 instruments were appropriate to primary health care settings because of simple wording, brief items, short administration time, and ease of scoring.ConclusionNo one assessment instrument captured all constructs of persistent pain. The 16 instruments provide a broad choice for primary care clinicians to assist with early identification of adults at risk of, or with persistent pain.

Advancing a National Agenda to Eliminate Disparities in Pain Care: Directions for Health Policy, Education, Practice, and Research

“…This evidence is unfortunate as primary care offers the best opportunity for early identification of patients at risk of developing chronic, persistent pain and long‐term disability [92]. Not surprisingly, models for clinical and cost‐effective pain treatment in primary care are currently lacking [93].…”

Use of Primary Healthcare Among Chinese Older Adults With Functional Limitations

“…Previous studies have shown that older people are less likely to recover from chronic pain compared with younger people (Whitlock et al, 2017). Early identification of disabled individuals with persistent pain or acute pain characteristics in PHC institutions should lead to timely referrals for a more specialized health assessment and comprehensive treatment (Grimmer-Somers et al, 2009). The identification of appropriate pain management strategies and timely intervention can avoid persistent pain, as well as reduce medical and compensation costs (Blyth et al, 2004; Blyth et al, 2004; Grimmer-Somers et al, 2009).…”

“…Early identification of disabled individuals with persistent pain or acute pain characteristics in PHC institutions should lead to timely referrals for a more specialized health assessment and comprehensive treatment (Grimmer-Somers et al, 2009). The identification of appropriate pain management strategies and timely intervention can avoid persistent pain, as well as reduce medical and compensation costs (Blyth et al, 2004; Blyth et al, 2004; Grimmer-Somers et al, 2009). Future investigations of PHC providers’ experiences in treating patients with pain, using both non-pharmacological interventions with rational and evidence-based approaches and pharmacological interventions following the World Health Organization’s pain ladder, are needed.…”

Obstáculos para retorno ao trabalho: tradução e adaptação cultural do questionário para o contexto brasileiro

“…Pesquisadores 18 apontam o ORTWQ como um instrumento que possui muitas vantagens como: ser de domínio público, ser multidimensional, apresentar validade e confiabilidade adequadas nas amostras em que foi utilizado e facilidade no cálculo dos escores. Além disso, esse questionário foi incluído em duas revisões sistemáticas da literatura 28,40 que fortemente recomendaram seu uso para avaliar questões ocupacionais múltiplas.…”