Background & Aims

Majority of the cancer patients suffer with chronic pain. Many pain assessment scales have been used but none has been fully qualified for all cancer patients; specially in a population where illiteracy is prevalent. We aim to evaluate the correlation between Visual analog scale (VAS) , Numeric rating scale (NRS) and 100 paisa pain scale(PPS) in cancer patients with chronic pain. We also assessed patients pain scale preference and sought a relationship between educational status and preferred pain scale. Taking into account varying educational backgrounds of Indian population expressing pain intensity in monetary magnitude in terms of PPS seems more acceptable in Indian population.

Methods

We conducted a cross sectional comparative study in Pain and Palliative clinic,VMMC and Safdarjung hospital,New Delhi. A total of 110 cancer patients who visited the OPD were asked to provide the pain intensity rating for 4 variables; current pain, maximum pain, minimum pain intensity during last 24 hours and average pain over last 7 days completed in a block using all 3 scales (VAS,NRS and PPS) in a randomised order.Patients were also asked to rate each scale as easy,average or difficult in terms of their understanding of each scale and hence give their preferred pain assessment scale.

Results

The analysis was performed on observations recorded from 110 cancer patients who visited the OPD. The intraclass correlation ( icc) estimates ranged from 0.83 ( NRS vs PPs) to 0.93 ( VAS vs PPS) at 95% confidence interval, with the lowest being for current pain intensity. The results suggested a good concordance between VAS vs PPS and between NRS vs PPS. The mean average pain score was 47.7 for VAS, 46.5 for PPS and 5.2 for NRS. The overall ease of understanding was 45% for VAS, 51% for NRS and 72% for PPS. Out of the 110 patients 44% were illiterate, 28% had only primary and 28% had secondary and other higher education. In all educational groups the preferred pain scale was PPS( p< 0.0001)

Conclusions

The results show a good correlation between VAS, NRS and PPS suggesting that these scales can be used interchangeably for pain assessment.The strength of agreement was good for all 4 variables; current, maximum, minimum and average pain intensity (icc 0.83-0.93). Majority of population in the study was illiterate and preferred PPS to VAS and NRS. The ease of understanding was maximum for PPS followed by VAS followed by NRS in our study. Hence, we conclude that PPS is the most suitable scale for assessing chronic cancer pain in Indian population .

References

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Presenting Author

Pallavi paruthi

Poster Authors

Pallavi Paruthi

MBBS, MD,DNB, CCEPC

VMMC and safdarjung hospital, ggsipu new delhi

Lead Author

Dr Dimple Pande

MBBS

Vmmc and safdarjung hospital, New Delhi

Lead Author

Dr Saveena Gulati

MBBS

Vmmc and safdarjung hospital, New Delhi

Lead Author

Dr Deepa Khurana

MBBS

Vmmc and safdarjung hospital, New Delhi

Lead Author

Dr Madhu Dayal

MBBS MD ANAESTHESIA

VMMC& SJH NEW DELHI

Lead Author

Dr Vandana Talwar

MBBS MD ANAESTHESIA

VMMC& SJH NEW DELHI

Lead Author

Dr Sujata Choudhary

MBBS

Vmmc and safdarjung hospital, New Delhi

Lead Author

Topics

  • Assessment and Diagnosis