Activity-Based Checks (ABCs) of Pain: A Functional Pain Scale Used by Surgical Patients

Ho, Bao Vincent K.; Beatty, Simon; Warnky, David; Sykes, Kevin J.; Villwock, Jennifer A.

doi:10.17161/kjm.vol15.15831

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…Prior studies have investigated its use in orthopedic and general surgical patients. 11,22 In this study focusing on urologic patients, the ABCs correlated to the NRS scale at baseline and post-operative appointments. While neither scale displayed a significant correlation to MME prescribed or MME taken, specific functions (ABCs), such as "Walking outside the room", correlated significantly with MME prescribed and taken.…”

Section: Discussionmentioning

confidence: 99%

“…These findings were similar to those published previously from the ABCs studies. 11,22 While there is growing recognition regarding the importance of functional pain assessment, there are no clear guidelines for which functions to include or how to assess them, particularly in the perioperative setting. 3,23 Functions like "sitting up" and "ambulation" elicit dynamic pain that may be directly relevant to post-operative recovery; these functions cannot be specifically captured by the NRS.…”

Section: Discussionmentioning

confidence: 99%

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Investigation of a Novel Activity-Based Checks (ABC) Functional Pain Scale in the Postoperative Urologic Surgery Patient

Warnky¹,

Diebolt²,

Ho³

et al. 2023

kjm

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Introduction. The authors investigated a novel functional pain scale, the Activity-Based Checks (ABCs) of Pain, following open urologic surgery. The primary objectives were to establish the strength of the correlation between the ABCs and the numeric rating scale (NRS) and determine the impact of functional pain on the patient’s opioid requirements. We hypothesized that ABC score would correlate strongly with NRS and that the ABC score during hospitalization would be more closely correlated with the number of opioids prescribed and used. Methods. This prospective study included patients at a tertiary academic hospital undergoing nephrectomy and cystectomy. The NRS and ABCs were collected pre-operatively, during the inpatient stay, and at the one-week follow-up. Milligrams of morphine equivalents (MMEs) prescribed at discharge and the MME reportedly taken during the first post-operative week were recorded. Spearman's Rho was used to assess the correlation between scale variables. Results. Fifty-seven patients were enrolled. The ABCs correlated strongly with the NRS at baseline and post-operative appointments (r = 0.716, p < 0.001 and 0.643, p < 0.001). Neither the NRS nor the composite ABCs score was predictive of outpatient MME requirements; the ABCs function, “Walking outside the room” significantly correlated to MMEs taken after discharge (r = 0.471, p = 0.011). The greatest predictor of MMEs taken was the number of MMEs prescribed (0.493, p = 0.001). Conclusions. This study highlighted the importance of post-operative pain assessment that takes functional pain into consideration to evaluate pain, inform management decisions, and reduce opiate reliance. It also emphasized the strong relationship between opioids prescribed and opioids consumed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Investigation of a Novel Activity-Based Checks (ABC) Functional Pain Scale in the Postoperative Urologic Surgery Patient

Warnky¹,

Diebolt²,

Ho³

et al. 2023

kjm

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“…All patients received standard laboratory tests such as complete blood counts and complete metabolic profile. Secondary endpoints included hospital LOS, postoperative complications and functional Activity Based Checks (ABC) pain scores 26,27 . Patients completed pain scales (ABCs of Pain, Appendix IIc) once daily to measure pain perception and their ability to perform basic functions whereas also considering specific body areas for pain.…”

Section: Methodsmentioning

confidence: 99%

The Use of Dissemination and Implementation to Improve Multimodal Analgesia in Head and Neck Surgery

et al. 2022

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Objectives: To optimize the delivery of multimodal analgesia to patients undergoing major head and neck oncologic surgeries.Methods: Pilot study included patients enrolled to receive either scheduled acetaminophen and as-needed opioids (control group) or scheduled acetaminophen, gabapentin, ketorolac, and as-needed opioids (experimental group). RCT, a hybrid type 1 effectiveness-implementation pragmatic trial, was designed to test the effectiveness of the intervention. Arm A received scheduled acetaminophen and as-needed opioids. Arm B received scheduled gabapentin, ketorolac, a regional nerve block at the free tissue donor site, scheduled acetaminophen and as-needed opioids.Results: Pilot: Thirty-one patients undergoing major head and neck surgery were enrolled. Mean MMEs administered in control group (n = 15) was 251.60 mg (SD = 224.57 mg); mean MMEs in Experimental group (n = 16) was 195.78 mg (SD = 131.08 mg), p = 0.401. LOS was 8.0 days in control versus 7.0 days in experimental group (p = 0.054).RCT: Interim analysis for safety and futility was planned during trial's design after 30 patients (n = 14 Arm A, and n = 16 Arm B). Mean MMEs administered were 135.1 mg in Arm A, (SD = 86.0 mg) versus mean MME of 51.3 mg in Arm B (SD = 43.3 mg, (p < 0.05)). Given clear superiority results, the trial was prematurely terminated. Functional pain scores, LOS, and complications were similar between the arms (p > 0.05). Variability of mean MME was compared before and after implementation of the management protocols: SD in RCT#1 was 181.46 mg versus 124.6 mg in RCT#2.Conclusion: Multimodal analgesia significantly reduced the need for opioids in patients undergoing major head and neck surgery.

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“…Tools such as the Numeric Rating Scale (NRS) and Wong-Baker Faces Pain Rating Scale (FACES) are highly subjective which may misrepresent pain intensity score and tolerable pain while overshadowing function and patient progress [1,25]. Additionally, studies have suggested that recorded pain levels do not reliably predict subsequent treatment [12,26]. Widely accepted scales are unidimensional; error may be introduced when attempting to gauge the intensity of pain at different points in time, during activities, and movements [4,12].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, studies have suggested that recorded pain levels do not reliably predict subsequent treatment [12,26]. Widely accepted scales are unidimensional; error may be introduced when attempting to gauge the intensity of pain at different points in time, during activities, and movements [4,12]. The complexity of the pain experience is even greater for patients with chronic pain because so many aspects and activities of their lives are impacted [4].…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of The Activity-Based Checks (ABCs) of Pain: A Functional Pain Scale

Virgen,

Wright,

Renslo

et al. 2024

Preprint

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The Activity Based-Checks of Pain (ABCs) is a pain assessment tool incorporating activities of daily living and instrumental activities of daily living. Unlike widely used pain scales which are oftentimes unidimensional and highly subjective, the ABCs was designed to focus on function capabilities and limitations of patients due to pain. This study sought out to validate the factorial structure of the ABCs and assess its use in participants with chronic pain. Participants were recruited in two phases from Prolific; an online service designed to identify research participant recruitment based on study criteria. Phase one optimized the design of the ABCs, with 297 subjects selecting their preferred icon for each function and rating its understandability. The most preferred and understandable icons were then used in phase two, where 304 chronic pain participants completed the ABCs, PROMIS-29, additional PROMIS items that were analogous to the ABCs functions but not represented in the PROMIS-29, and the Brief Pain Inventory (BPI). Data was analyzed using exploratory factor analysis and confirmatory factor analysis demonstrating four factor loadings: multi-planal activities, sitting/hip flexor pain, walking/ambulation, and pain interference with lightweight unilateral activities. High internal consistency was demonstrated with all four factor loadings. Correlations between items in the ABCs, PROMIS, and BPI resulted in moderate to strong correlations demonstrating strong evidence for the validity of the ABCs as a functional pain assessment tool.

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Activity-Based Checks (ABCs) of Pain: A Functional Pain Scale Used by Surgical Patients

Cited by 3 publications

References 9 publications

Investigation of a Novel Activity-Based Checks (ABC) Functional Pain Scale in the Postoperative Urologic Surgery Patient

Investigation of a Novel Activity-Based Checks (ABC) Functional Pain Scale in the Postoperative Urologic Surgery Patient

The Use of Dissemination and Implementation to Improve Multimodal Analgesia in Head and Neck Surgery

Development and Validation of The Activity-Based Checks (ABCs) of Pain: A Functional Pain Scale

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