1
|
Taub C, Gordon KS, Goulet J, Lee A, Mayhew M, Von Korff M, DeBar L, Kerns RD. Graded chronic pain scale revised: validation in a Veteran sample. Pain Med 2023; 24:1169-1175. [PMID: 37220899 PMCID: PMC10546477 DOI: 10.1093/pm/pnad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The Graded Chronic Pain Scale (GCPS) is frequently used in pain research and treatment to classify mild, bothersome, and high impact chronic pain. This study's objective was to validate the revised version of the GCPS (GCPS-R) in a US Veterans Affairs (VA) healthcare sample to support its use in this high-risk population. METHODS Data were collected from Veterans (n = 794) via self-report (GCPS-R and relevant health questionnaires) and electronic health record extraction (demographics and opioid prescriptions). Logistic regression, adjusting for age and gender, was used to test for differences in health indicators by pain grade. Adjusted odds ratio (AOR) with 95% confidence intervals (CIs) were reported with CIs not including an AOR of 1 indicating that the difference exceeded chance. RESULTS In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 49.3%: 7.1% with mild chronic pain (mild pain intensity and lower interference with activities); 23.3% bothersome chronic pain (moderate to severe pain intensity with lower interference); and 21.1% high impact chronic pain (higher interference). Results of this study mirrored findings in the non-VA validation study; differences between bothersome and high impact were consistent for activity limitations and present but not fully consistent for psychological variables. Those with bothersome chronic pain or high impact chronic pain were more likely to receive long-term opioid therapy compared to those with no/mild chronic pain. CONCLUSIONS Findings highlight categorical differences captured with the GCPS-R, and convergent validity supports use of the GCPS-R in US Veterans.
Collapse
Affiliation(s)
- Chloe Taub
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
- Blue Note Therapeutics, San Fransisco, CA 94104, United States
| | - Kirsha S Gordon
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Joseph Goulet
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Allison Lee
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT 06511, United States
| | - Meghan Mayhew
- Kaiser Permanente Center for Health Research, Portland, OR 97227, United States
| | - Michael Von Korff
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States
| | - Lynn DeBar
- Kaiser Permanente Center for Health Research, Portland, OR 97227, United States
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States
| | - Robert D Kerns
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT 06511, United States
| |
Collapse
|
2
|
Till SR, Schrepf A, Clauw DJ, Harte SE, Williams DA, As-Sanie S. Association Between Nociplastic Pain and Pain Severity and Impact in Women With Chronic Pelvic Pain. J Pain 2023; 24:1406-1414. [PMID: 36958459 PMCID: PMC10511662 DOI: 10.1016/j.jpain.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/25/2023]
Abstract
Exploring the relationship between nociplastic pain and the severity and impact of pelvic pain symptoms could lend insight into the heterogeneous symptom presentation and treatment response that complicates management of chronic pelvic pain. In this prospective cross-sectional study, we sought to evaluate relationships between degree of nociplastic pain, measured by the Fibromyalgia (FM) Survey Score, and multiple aspects of the chronic pelvic pain (CPP) experience, including severity, frequency, tenderness during pelvic myofascial exam, interference with daily life, and high-impact pain. The study included 303 women who presented to a tertiary referral clinic for chronic pelvic pain and endometriosis. Multiple measures of pelvic pain, including pain severity, frequency, interference, pelvic myofascial pain, and high-impact pain were examined in General Linear Models with FM Survey Score as the primary predictor of interest in models controlling for endometriosis, surgical history, use of opioids, body mass index, and patient age. Higher level of nociplastic pain was associated with greater pelvic pain severity, frequency, interference, and pelvic myofascial pain (all P < .05). For all models, degree of nociplastic pain was more strongly associated with pain outcomes than the presence of endometriosis, and use of opioids was the only stronger predictor of worse pain outcomes. The likelihood of high impact pain increased 7% for each additional point on the FM Survey Score. Degree of nociplastic pain was robustly associated with severity, frequency, and impact of pelvic pain, and was independent of the presence of endometriosis, history of surgical procedures for pelvic pain, age, and BMI. Trial registration: not applicable PERSPECTIVE: This article evaluates the impact of nociplastic pain on symptoms and functional status in chronic pelvic pain. These findings raise the possibility that a simple screening tool for nociplastic pain might provide clinically actionable information without the need for deep neurobiological phenotyping and may inform development of personalized management strategies.
Collapse
Affiliation(s)
- Sara R Till
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan..
| | - Andrew Schrepf
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Daniel J Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - David A Williams
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|