A brief pain diary for ambulatory patients with advanced cancer - Acceptability and validity

BACKGROUND. Undertreatment of pain is common among ambulatory patients with advanced cancer. Available pain assessment tools are complex and not easy to use in ambulatory care settings. METHODS. The authors developed and assessed the acceptability and psychomet ric properties of a simple, brief 4-week pain diary for ambulatory care ass essing 3 indicators: current pain intensity on rising and retiring, number of daily rescue doses, and weekly impact of pain on quality of life. Select ed European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire subscales were administered once concurrently for validation purposes. Subjects were 98 adult French-speaking ambulatory patients with advanced cancers who were on opioids, free of apparent cognitive impairment , and recruited through 2 oncology clinics in Quebec City, Quebec, Canada. RESULTS. In the first 3 weeks, greater than or equal to 80% of patients com pleted all requested diary data. Internal consistencies of the 5-item scale assessing pain impact on quality of life were 0.87-0.92 over the study per iod. Pain intensity predicted both increased use of rescue doses and negati ve pain impact on quality of life. This latter scale was also responsive to decreases in pain intensity over 1-week intervals. As hypothesized, pain i ntensity, rescue doses, and pain impact on quality of life correlated with EORTC scale scores. Pain intensity correlated most strongly with the EORTC pain and global quality of life scales (r = 0.65 and -0.55, respectively). CONCLUSIONS. This diary is simple, very brief, acceptable to patients, and appears to be valid. It can thus likely be used to monitor pain management for advanced cancer patients. Cancer 2000;88:2387-97. (C) 2000 American Can cer Society.