Pain Assessment: A Practical Guide for Researchers and Clinicians

Abstract

Pain is one of the most universal experiences of humankind, affecting all populations across the globe. In the United States over 100 million individuals are reported to be suffering with chronic pain (Institute of Medicine in Relieving pain in America: a blueprint for transforming prevention, care, education and research, The National Academies Press, Washington, 2011) and approximately 80 % of all medical visits stem directly from pain complaints (Quartana et al. in Expert Rev Neurother 9:745-758, 2009). This paper discusses a recent movement toward standardization of the pain assessment process to improve the quality of patient reported outcomes in clinical trials through the work of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) workgroup and the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) Roadmap Initiative. We review pain assessment from the framework of the recommendations of IMMPACT including the key assessment domains and the specific instruments recommended for use. We also review the PROMIS item banks and their usefulness in fulfilling the spirit of the IMMPACT recommendations. Finally, we discuss important assessment domains that could be a part of all comprehensive pain assessments that were not addressed by IMMPACT or PROMIS and make recommendations for adoption for clinical practice.