Empirical comparison of commonly used measures to evaluate pain treatment in cancer patients with chronic pain

Purpose: There is limited consensus about the most appropriate measures to evaluate the adequacy of pain treatment in cancer patients. There are no kn own studies describing commonly used measures to simultaneously evaluate th e adequacy of cancer pain treatment. The purpose of this study was to compa re measures, which are frequently reported in the literature, to assess the adequacy of pain treatment in cancer patients with chronic pain. This stud y was part of a randomized controlled trial. Patients and Methods: In total, 313 cancer patients with a pain duration of at least 1 month were evaluated. After a baseline measure in the hospital, patients were followed up at 2, 4, and 8 weeks after discharge at home. Ad equacy of cancer pain treatment was evaluated by means of four different ty pes of outcome measures. The four types included three pain intensity marke rs based on patients' pain intensity, a pain relief scale, a patient satisf action scale, and three pain management indexes that related patients' pain medication with pain intensity, Results: The proportion of inadequately treated pain patients varied extrem ely. Depending on the outcome measure used, the percentage of inadequately treated patients ranged from 16% to 91%. The choice of measure, rather than pain treatment itself, determined the proportion of inadequacy. Conclusion: There is an urgent need for consensus about how to evaluate the effectiveness of pain treatment. Studies that evaluate adequacy of pain tr eatment should be interpreted with caution. Further research is necessary t o elucidate the validity and reliability of outcome measures simultaneously , (C) 1999 by American Society of Clinical Oncology.