The Amsterdam Pain Management Index compared to eight frequently used outcome measures to evaluate the adequacy of pain treatment in cancer patients with chronic pain

There is no 'gold standard to assess the adequacy of pain treatment in canc er patients. The purpose of the study is to explore the Amsterdam Pain Mana gement Index, a newly designed measure to evaluate the adequacy of cancer p ain treatment, and to compare it with eight frequently used outcome measure s. The Amsterdam Pain Management Index compares patients Present Pain Inten sity, Average Pain Intensity. and Worst Pain Intensity with a composite sco re of analgesics used, while correcting for what a patient considers as a t olerable level of pain. The eight frequently used outcome measure consisted of three Pain Intensity Markers, the Pain Relief Scale, the Patient Satisf action Scale, and three Pain Management Indexes In a randomized controlled trial, 313 cancer patients with a pain duration of at least 1 month were in cluded and followed-up three times until 2 months postdischarge at home. Th e experimental group received a Pain Education Program, consisting of tailo red pain information and instruction. Results showed that, except for the t hree Pain Management Indexes. the agreement between the measures was very l ow to moderate. The test of known-groups comparisons and equivalence betwee n groups indicated that the Amsterdam Pain Management Index showed promisin g results. The Pain Intensity Markers and the Pain Relief Scale were limite d in discriminating between groups, while the Patient Satisfaction Scale sh owed no differences between patient groups. Although it was possible for th e Pain Management Indexes to distinguish between patient groups, the differ ences were not in the expected direction. The ability of the outcome measur es to detect changes over time was clearly demonstrated by all outcome meas ures. Effects of the intervention were only found for the Amsterdam Pain Ma nagement Index and patients' Substantial Worst Pain score. Although support was provided for the use of the Amsterdam Pain Management Index, more rese arch is warranted. (C) 2001 International Association for the Study of Pain . Published by Elsevier Science B.V. All rights reserved.