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N+R-Vol-2

4 vere pain begins – with the majority of healthcare professionals rating severe pain to start anywhere be- tween 4 and 8 on an 11-point NRS (Varrassi, 2010). Furthermore, due to inadequate assessment skills and time constraints clinicians frequent- ly have difficulties in understanding the level of pain reported by pa- tients (Berry, 2001). Assessing quality of life aspects is also important to improve the suc- cess of pain management. Several detailed questionnaires exist, e.g. SF-36/SF-12, WOMAC, EuroQoL (EQ- 5D), providing information on various aspects such as limitation of daily activities, patient energy, emotional health problems and social activity. But since these tools are relatively time consuming, they are more suitable for pain specialists rather than general practitioners. CHANGE PAIN Scale Based on the Individual Treatment Target, defined by Müller-Schwefe and Ueberall (2006), the CHANGE PAIN Advisory Board has adapted a new tool helping to improve pa- tient-physician communication by identifying key elements of treat- ment success and expectations of References 1. Müller-Schwefe GHH, Ueberall MA. Pain Inten- sity of Patients with Chronic Low-Back Pain- Induced Restrictions to follow Standardized Rehabilitation Programs are Frequently Un- derestimated by Physicians and Physiothera- pists - Results of a Prospective German Quality Assurance Program,WIP Poster 2, Pro- ceedings of WIP Conference, 2004. 2. Glajchen M. Chronic pain: treatment barriers and strategies for clinical practice. J Am Board Fam Pract, 2001, 14:211-218 3. Roper Starch Worldwide, Inc. Chronic pain in America: Roadblocks to Relief. 1999. www. ampainsoc.org 4. McCracken LM, Evon D, Karapas ET. Satisfac- tion with treatment for chronic pain in a spe- ciality service: preliminary prospective results. Eur J Pain, 2002, 6:387-393. 5. Varrassi G, Nossol S,Wiemer S. CHANGE PAIN Physician Survey at EFIC 2009. Physi- cians' perception on management of severe chronic non-cancer pain. Abstracts of the 3rd International Congress on Neuropathic Pain. Athens, 2010. 6. Berry PH et al. Pain: current understanding of assessment, management, and treatments. Reston,Va. National Pharmaceutical Council and Joint Commission on Accreditation of Healthcare Organizations, December 2001. 7. Ueberall MA, Müller-Schwefe GHH. Individual TreatmentTargets in Chronic Pain Manage- ment, Proceedings of EFIC, 2006, Istanbul. COMMENTARY Dr Gerhard H.H. Müller-Schwefe, President of the German Association for Pain Therapy (DGS), Germany In order to manage chronic pain successfully, physicians need a clear understanding of their individual patients. Pain intensity by it- self does not mean very much. It is always correlated to quality of life impairment, e.g. with respect to sleep quality, general activity and mood. Many instruments are available to assess the impairment of quality of life related to pain but these tools are usually time consuming.The new CHANGE PAIN Scale is a quick and user-friendly instrument to enhance communication between physicians and patients by establishing individual treatment targets. It allows the physician to assess the pain intensity of a particular pa- tient and also to evaluate the daily impairment. This information will help the physician to choose the right treatment. the patient. The present pain level is assessed on an 11-point NRS and related to the individual treat- ment goal in terms of pain sever- ity. In addition, the impact of pain on everyday living with regard to quality of life aspects is evaluated. This helps physicians and patients to agree on the need for improve- ment to set realistic expectations and individual treatment targets. Need for improvement Sleep General Activity Ability to Work Relations with other people Mood Side Effects not at all a little very much 0 1 2 3 4 5 6 7 8 9 10Present Pain Level Tolerable Pain Level Pain as bad as you can imagine No Pain SCALE