Pilot field testing of the chronic pain classification for ICD-11: the results of ecological coding

Barke, Antonia; Korwisi, Beatrice; Casser, Hans-Raimund; Fors, Egil Andreas; Geber, Christian; Schug, Stephan A.; Stubhaug, Audun; Ushida, Takahiro; Wetterling, Thomas; Rief, Winfried; Treede, Rolf‐Detlef

doi:10.1186/s12889-018-6135-9

Cited by 40 publications

(38 citation statements)

References 33 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, it is important to underline that the applied rating procedure was restricted in that the examiners did not meet the participants and had received no formal training in ICD‐11. Furthermore, the first study on field testing data found a good acceptance of the proposed classification and only few cases with double‐diagnoses (Barke et al, ).…”

Section: Discussionmentioning

confidence: 99%

Application of ICD‐11 among individuals with chronic pain: A post hoc analysis of the Stanford Self‐Management Program

Hornemann

Schröder

Ørnbøl

et al. 2019

European Journal of Pain

View full text Add to dashboard Cite

Background Chronic primary pain (CPP) is one of seven diagnostic groups within the proposed classification of chronic pain in ICD‐11. Our aims were to apply the proposed ICD‐11 criteria in a large cohort of chronic pain patients participating in the Chronic Pain Self‐Management Program (CPSMP) and further investigate whether participants with CPP differed from participants with chronic secondary pain (CSP) regarding health, health expenditure and the effect of participating in the CPSMP. Methods A secondary analysis of a randomized, controlled trial on the effect of the CPSMP. Four examiners categorized participants’ pain according to ICD‐11 using register‐based medical diagnoses and patients’ self‐reported symptoms. Afterwards, differences between CPP and CSP were examined. Results Out of 394 participants, 312 were successfully classified into CPP (n = 164) or CSP (n = 148) whereas 76 had a mixed pain condition. Participants with CPP were younger, more likely to be women, and had longer pain duration compared to participants with CSP. Participants with CPP reported worse health‐related quality of life on the SF‐36 Mental Component Summary and subscales of vitality, social functioning and bodily pain. Participants with CSP had more physical comorbidities and higher total health expenditure. None of the groups benefitted from the CPSMP. Conclusions We successfully applied the new classification of chronic pain in ICD‐11 on the basis of ICD‐10 medical diagnoses and symptom self‐report. Participants with CPP differed significantly from participants with CSP on baseline characteristics, self‐reported health measures and total health expenditure. The CPSMP was not effective in any of the groups. Significance The current study applies the proposed new classification of chronic pain in ICD‐11 and shares the experiences of the diagnostic rating procedure of individuals with chronic pain. Furthermore, it evaluates the effect of the Stanford Self‐Management Program.

show abstract

Section: Discussionmentioning

confidence: 99%

Application of ICD‐11 among individuals with chronic pain: A post hoc analysis of the Stanford Self‐Management Program

Hornemann

Schröder

Ørnbøl

et al. 2019

European Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Study limitations: Despite accessing several years' data from a large pain registry, the number of patients with CRP was relatively small, yet similar to the low rates of referral to pain clinics in other studies. 6 Patients referred to specialist pain clinics may not be generally representative of all patients with CRP. The categorization of patients as having CRP or not was based on their self-report.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial characteristics of cancer‐related pain in patients attending specialist pain clinics in Australia and New Zealand

2020

View full text Add to dashboard Cite

BACKGROUND Opioids have been the mainstay of cancer pain relief for the past 40 years, but a multidimensional, biopsychosocial approach to assessment and treatment is now recommended. 1 The intensity of cancer pain and the distress it causes are well known, but it is less clear what patients with cancer think about their pain and how they cope with it. The electronic Persistent Pain Outcomes Collaboration (ePPOC) is an integrated pain outcomes center established in Australia and New Zealand (ANZ) in 2013 to standardize data collection from patients attending outpatient pain clinics. Before their first clinic visit, patients self-report their demographics, clinical status (pain history, including a checklist for how they think their pain began; comorbidities; medications; health care utilization), and responses to four validated questionnaires-Brief Pain Inventory short form (BPI-SF), Depression Anxiety Stress Scales-21 (DASS-21), Pain Self-Efficacy Questionnaire (PSEQ), and Pain Catastrophizing Scale (PCS). The aim of this study was to interrogate the ePPOC dataset to determine (1) pain intensity, pain interference, mood, and pain cognitions in patients with cancer-related pain (CRP), (2) how these data compare to those in patients with chronic non-cancer pain, and (3) whether demographic or clinical variables predict self-efficacy and catastrophizing in patients with CRP. 2 | METHODS 2.1 | Participants Ambulatory patients with chronic pain attending specialist pain clinics participating in the ePPOC initiative between June 2013 and December 2016 and who completed the pre-consultation questionnaire were included. Patients were identified as having CRP if they selected "related to cancer" from the how-pain-began checklist. The study was approved by the University of Sydney Human Research Ethics Committee. 2.2 | Questionnaires and their categorization Patients self-reported responses to the following questionnaires: • BPI-SF: assesses pain intensity and interference with activity and enjoyment of life in the past week. Clinically relevant cut-points for patients with cancer are 0 to 4 for mild, 5 to 6 for moderate and 7 to 10 for severe. 2 • DASS-21: assesses severity of depression, anxiety, and stress over the past week. For each subscale, scores are classified either as normal (0-9 for depression, 0-7 for anxiety, 0-14 for stress), mild (10-13 for depression, 8-9 for anxiety, 15-18 for stress), moderate (14-20 for depression, 10-14 for anxiety, 19-25 for stress), severe (21-27 for depression, 15-19 for anxiety, 26-33 for stress), or extremely severe (≥28 for depression, ≥20 for anxiety, ≥34 for stress). 3 • PSEQ: assesses how strongly the patient believes he or she can perform a range of activities despite pain. Lower scores indicate less confidence to perform. In this study, self-efficacy was categorized as 0 to 19 for severe, 20 to 30 for moderate, 31 to 40 for mild, ≥41 for minimal. 4 • PCS assesses helplessness, magnification, and rumination in relation to pain, higher scores being worse. The cut points used ...

show abstract

“…The content models were developed by the seven author teams, and were then entered as children of the appropriate parent entities via the WHO proposal platform. Preliminary versions of the classification were 3 The prefinal version was further subjected to the official international field testing of the WHO via the IASP website.…”

Section: Methodsmentioning

confidence: 99%

Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)

Treede

Rief

Barke

et al. 2019

Pain

Self Cite

1,846

1,161

View full text Add to dashboard Cite

Chronic pain is a major source of suffering. It interferes with daily functioning, and often is accompanied by distress. Yet, in the International Classification of Diseases (ICD), chronic pain diagnoses are not represented systematically. The lack of appropriate codes renders accurate epidemiological investigations difficult and impedes health policy decisions regarding chronic pain. This hinders adequate financing of treatments for chronic pain patients, limiting access to multimodal care. In cooperation with the WHO, an IASP Working Group has developed a classification system that is applicable in a wide range of contexts, including pain medicine, primary care, and low-resource environments. Chronic pain is defined as pain that persists or recurs for more than three months. In chronic pain syndromes, pain can be the sole or a leading complaint and requires special treatment and care. In conditions such as fibromyalgia or nonspecific low back pain, chronic pain may be conceived as a disease in its own right; in our proposal, we call this subgroup 'chronic primary pain'. In six other subgroups, pain is secondary to an underlying disease: chronic cancer-related pain, chronic neuropathic pain, chronic secondary visceral pain, chronic posttraumatic and postsurgical pain, chronic secondary headache and orofacial pain, and chronic secondary musculoskeletal pain. These conditions are summarized as 'chronic secondary pain' where pain may at least initially be conceived as a symptom. Implementation of these codes in the upcoming 11 th edition of ICD will lead to improved classification and diagnostic coding, thereby advancing the recognition of chronic pain as a health condition in its own right.

show abstract

Pilot field testing of the chronic pain classification for ICD-11: the results of ecological coding

Cited by 40 publications

References 33 publications

Application of ICD‐11 among individuals with chronic pain: A post hoc analysis of the Stanford Self‐Management Program

Application of ICD‐11 among individuals with chronic pain: A post hoc analysis of the Stanford Self‐Management Program

Psychosocial characteristics of cancer‐related pain in patients attending specialist pain clinics in Australia and New Zealand

Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)

Contact Info

Product

Resources

About