HIGHLIGHTS
- •We introduce several indices of pain intensity that can be derived from EMA.
- •Patients, providers, and clinical trialists were interviewed about the EMA indices.
- •Each stakeholder group had a distinct preference hierarchy for different indices.
- •Multiple temporal characteristics of pain intensity are relevant for stakeholders.
Abstract
Pain assessment that fully represents patients’ pain experiences is essential for
chronic pain research and management. The traditional primary outcome measure has
been a patient's average pain intensity over a time period. In this series of 3 articles, we examine whether
pain assessment can be enhanced by considering additional outcome measures capturing
temporal aspects of pain, such as pain maxima, duration, and variability. Ecological
momentary assessment makes the assessment of such indices readily available. In this
first article, we discuss the rationale for considering additional pain indices derived
from ecological momentary assessment and examine which are most important to stakeholders.
Patients (n = 32), clinicians (n = 20), and clinical trialists (n = 20) were interviewed about their preference rankings for Average, Worst, and Least
Pain, Time in High Pain, Time in No/Low Pain, Pain Variability, and Pain Unpredictability.
Each stakeholder group displayed a distinct preference hierarchy for different indices,
and there were few commonalities between groups. Patients favored Worst Pain and Time
in High Pain, followed by Pain Variability and Unpredictability. Trialists favored
Average Pain, whereas clinicians favored Worst Pain. Results suggest that multiple
temporal aspects of pain are relevant for stakeholders and should be considered when
evaluating the efficacy of pain management.
Perspective
Examining which aspects of pain are most important to measure from the perspective
of different stakeholders can facilitate efforts to include all relevant treatment
outcomes. Our study suggests that multiple temporal aspects of pain intensity are
important to stakeholders. This should be considered when evaluating the efficacy
of pain management.
Key words
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Article info
Publication history
Published online: September 14, 2020
Footnotes
A.A.S. is a Senior Scientist with the Gallup Organization and a consultant with IQVIA and Adelphi Values, Inc. The remaining authors have no conflict of interest to declare.
This work was supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR066200; A.A.S. and S.S., principal investigators).
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© 2020 by United States Association for the Study of Pain, Inc.
