Comparison of numerical and verbal rating scales to measure pain exacerbations in patients with chronic cancer pain

Brunelli, Cinzia; Zecca, Ernesto; Martini, Cinzia; Campa, Tiziana; Fagnoni, Elena; Bagnasco, Michela; Lanata, Luigi; Caraceni, Augusto

doi:10.1186/1477-7525-8-42

Cited by 122 publications

(107 citation statements)

References 38 publications

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“…However, the pain intensity at time of meaningful pain relief has never been assessed. In the measurement of cancer pain exacerbations, patients commonly use numerical rating scales more appropriately than verbal scales 7 . Numerical scales have been commonly used as a single entity, percentage pain intensity difference, the sum of pain intensity differences, pain relief, and percentage of maximum total pain relief.…”

Section: Introductionmentioning

confidence: 99%

Meaningful cut-off pain intensity for breakthrough pain changes in advanced cancer patients

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Adile

Torta

et al. 2012

Current Medical Research and Opinion

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c i a l D i s t r i b u t i o n U n a u t h o r i z e d u s e p r o h i b i t e d . A u t h o r i s e d u s e r s c a n d o w n l o a d , d i s p l a y , v i e w a n d p r i n t a s i n g l e c o p y f o r p e r s o n a l u s eCurrent Medical Research & Opinion Vol. 29, No. 1, 2013, 93-97 To assess the level of pain intensity at which patients feel the impetus to ask for a breakthrough cancer pain (BTcP) medication, and level of pain intensity at which patients consider they have achieved acceptable pain control after receiving a BTcP medication. Methods:A consecutive sample of patients who were receiving oral morphine equivalents equal to or more than 60 mg daily, and were prescribed rapid onset opioids for the management of episodes of BTcP, were included in the study. Focused educational activities regarding BTcP and numerical scales were established during hospital admission. At discharge patients were interviewed to find out what was the pain intensity level which gave the impetus to take the BTcP medication, what was the pain intensity for acceptable pain control after a BTcP medication had been given, and which factors prevented the patient calling for BTcP medication. A brief COPE (coping orientation to problems experienced) questionnaire was also administered. Results:Fifty-two patients were recruited for this study. The meaningful pain intensity for asking for a BTcP medication was 7.1; 77% of patients had a pain intensity of 7-8 on a numerical scale of 0-10. The meaningful pain intensity for adequate analgesia after a BTcP medication was 3.5. Similarly, 77% of patients had a pain intensity of 3-4. There was no relationship with the variables examined. Concerns by patients about the use of BTcP medications were minimal. Conclusion:The meaningful BTcP intensity and pain intensity expected after BTcP medication can be useful in selecting patients in studies of BTcP. The principal limitation of this study was the specific setting of an acute unit with specific features and the relatively low number of patients. This observation should be followed up by further surveys with a larger number of patients and different settings.

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Section: Introductionmentioning

confidence: 99%

Meaningful cut-off pain intensity for breakthrough pain changes in advanced cancer patients

Mercadante

Adile

Torta

et al. 2012

Current Medical Research and Opinion

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“…However, in a systematic review of 54 studies comparing unidimensional scales, a nrs demonstrated better compliance in 15 of 19 studies comparing it with a vas and a vrs, and it was the recommended tool in 11 studies on the basis of higher compliance rates, better responsiveness and ease of use, and good applicability relative to a vas or vrs 28 . Brunelli et al 29 also demonstrated that, in cancer patients, a nrs was better than a vas in distinguishing between background pain and peak pain intensity, with a lower proportion of patients giving inconsistent evaluations (14% vs. 25%). In addition a nrs showed higher reproducibility in the measurement of pain exacerbation.…”

Section: Assessment Guides and Toolsmentioning

confidence: 99%

Canadian Recommendations for the Management of Breakthrough Cancer Pain

et al. 2016

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Breakthrough cancer pain (btcp) represents an important element in the spectrum of cancer pain management. Because most btcp episodes peak in intensity within a few minutes, speed of medication onset is crucial for proper control. In Canada, several current provincial guidelines for the management of cancer pain include a brief discussion about the treatment of btcp; however, there are no uniform national recommendations for the management of btcp. That lack, accompanied by unequal access to pain medication across the country, contributes to both regional and provincial variability in the management of btcp.Currently, immediate-release oral opioids are the treatment of choice for btcp. This approach might not always offer optimal speed for onset of action and duration to match the rapid nature of an episode of btcp. Novel transmucosal fentanyl formulations might be more appropriate for some types of btcp, but limited access to such drugs hinders their use. In addition, the recognition of btcp and its proper assessment, which are crucial steps toward appropriate treatment selection, remain challenging for many health care professionals.To facilitate appropriate management of btcp, a group of prominent Canadian specialists in palliative care, oncology, and anesthesiology convened to develop a set of recommendations and suggestions to assist Canadian health care providers in the treatment of btcp and the alleviation of the suffering and discomfort experienced by adult cancer patients.

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“…La variable de salida, magnitud del dolor se estimó utilizando la escala análoga del dolor; la primera versión de este instrumento fue introducida por Downie en 1978 10 , y ha sido satisfactoriamente evaluada en tiempo reciente, reflejando una alta capacidad discriminatoria para diferenciar el dolor subyacente de los picos de dolor y también una alta reproducibilidad (Kappa de Cohen 0,86), comparada con las escalas visuales del dolor 11 . Mediante este instrumento las pacientes clasifican la magnitud del dolor en valores numéricos que van de 0 a 10, siendo 0 la ausencia de dolor y 10 el máximo dolor imaginable.…”

Section: Materialses Y Métodosunclassified

Caracterización del dolor perineal postparto en puérperas

et al. 2016

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ResumenIntroducción: El dolor perineal posparto es un problema clínico frecuente, no abordado en profundidad en Colombia. Objetivo: Determinar la prevalencia, severidad y posibles factores asociados con el dolor perineal postparto en una muestra de mujeres en el Hospital La Victoria-Instituto Materno Infantil de Bogotá. Materiales y métodos: Estudio observacional prospectivo. Se evaluó el grado de dolor perineal percibido en 133 pacientes en posparto, mediante la escala análoga numérica de dolor, estando acostada, sentada, caminando y yendo al baño (micción y/o defecación), a las 12 y 48 horas postparto. Datos demográficos, del parto y recién nacido fueron tomados directamente de las historias clínicas. Resultados: Prevalencia global del dolor perineal moderado a severo 36-39,5% dependiendo de la actividad a las 12 horas del parto y entre 28-31,6% a las 48 horas. El dolor perineal se encontró asociado, en cualquiera de las actividades valoradas, con el uso de analgesia epidural durante el trabajo de parto, desgarro grado II o mayor, peso y perímetro cefálico del recién nacido. Se registra mejor efecto analgésico con dosis de acetaminofén de 3 g diarios o más. Conclusiones: El dolor perineal moderado a severo afecta a menos del 50% de las mujeres postparto vaginal; se asocia con la frecuencia y magnitud del trauma perineal. Los resultados sugieren la necesidad de profundizar en el estudio del manejo analgésico más adecuado para estas pacientes. AbstractIntroduction: Postpartum perineum pain is a common clinical problem, which is not addressed in detail in Colombia. Objective: To assess prevalence, magnitude and possible factors associated with postpartum perineum pain in a sample of women in the Hospital La Victoria-Instituto Materno Infantil , in Bogotá. Materials and methods: A prospective observational study was performed where the degree of perineum pain perceived by 133 postpartum patients was evaluated by using numerical analog scale of pain when they were sitting down, lying, walking and going to the bathroom (urination and/or defecation), at 12 and 48 hours of postpartum . Demographic, birth and newborn data were taken directly from the medical records. Results: Overall prevalence of moderate to severe perineum pain

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Comparison of numerical and verbal rating scales to measure pain exacerbations in patients with chronic cancer pain

Cited by 122 publications

References 38 publications

Meaningful cut-off pain intensity for breakthrough pain changes in advanced cancer patients

Meaningful cut-off pain intensity for breakthrough pain changes in advanced cancer patients

Canadian Recommendations for the Management of Breakthrough Cancer Pain

Caracterización del dolor perineal postparto en puérperas

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