Pain Assessments

When the Institute of Medicine (IOM) published its landmark report in 2011, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research, one of its high priority recommendations was:

Recommendation 3-6. Provide consistent and complete pain assessments. Health care providers should provide pain assessments that are consistent and complete and documented so that patients will receive the right care at the right place and the right time.

The National Pain Strategy Report, a plan for operationalizing the IOM report’s recommendations, is more specific. Objective 3 of the Report’s Prevention and Care section states, “Pain assessment should be multifaceted and include self-report as well as clinician examination.” It goes further to say that “assessment and outcomes measures should include relevant pain, physical, psychological, and social domains of functioning that conform to the biopsychosocial model of pain as well as patient-reported outcomes and patient-defined goals.”

The next two issues of the PAINS Educational Brief series will highlight two strategies for accomplishing this objective. First we will review PASTOR, the Pain Assessment Screening Tool and Outcomes Registry. PASTOR is a survey that produces a comprehensive 3-page clinician report of a patient’s chronic pain. At its core, PASTOR uses instruments developed by the National Institutes of Health (NIH), collectively known as the Patient Reported Outcomes Measurement Information System (PROMIS), to administer questions in a wide range of pain related areas. We are grateful to retired Colonel Dr. Chester “Trip” Buckenmaier, Program Director for the Defense and Veterans Center for Integrative Pain Management (DVCIPM), for providing PAINS with the following brief which has been reviewed and approved by the DVCIPM. The next issue of the PAINS Educational Brief series will be authored by Dr. Sean Mackey at Stanford University, who has translated PASTOR for civilian healthcare providing institutions.

PAINS is committed to collecting and disseminating promising innovative work to improve chronic pain care whether via improved clinical or policy approaches. We invite readers to submit innovative initiatives to be considered for publication by the editors of the PAINS Educational Brief series.