Assessment of chronic pain: multidimensional tools, applicability, and practicality

Introduction: Chronic pain (CP) negatively impacts patients’ physical and psychological status. Thus, it has the potential to affect every aspect of everyday life. In Portugal, CP is a major public health problem that affects roughly 36.7% of adults. Nevertheless, assessment of this condition is still far from ideal. A Portuguese study showed that most of last year’s medical students and first-year residents did not routinely assess pain. Additionally, the best-known pain assessment tools are the ones that focus only on pain intensity, thus disregarding the multidimensional nature of pain. Objectives: This study aims to review pain assessment tools that consider the nature of pain and its impact on patients' functionality. The ultimate goal is to increase the knowledge and dissemination of such tools. Methods: Focus groups were conducted with a panel of 29 Portuguese physicians specialized in family medicine and orthopaedics. Several pain assessment tools were debated regarding applicability, practicality, and relevance. After group discussion, five pain assessment tools were considered particularly relevant. Results: The characteristics, advantages, and disadvantages of five pain assessment tools (ACT-UP, CAPA, Barthel index, BPI, and EQ-5D), and the need for their applicability in the family medicine clinical practice are summarized and highlighted. Functional assessment of CP patients is a key step to deciding the most adequate treatment regimen since the individual nature of patients will cause them to be differently affected by distinct limitations, even if the intensity of pain is similar. Conclusion: The implementation use of these tools in clinical practice will be crucial for the improvement of CP management.