Skip to main content

03.04.2024

Tools for Bedsite Pain Assessments in Chronic Pancreatitis

verfasst von: Louise Kuhlmann, MD, PhD, Asbjørn Mohr Drewes, MD, PhD, DMSc

Erschienen in: Current Treatment Options in Gastroenterology

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Chronic pancreatitis (CP), a condition marked by severe pain, necessitates precise pain assessment for effective treatment. This review explores recent advances in CP pain assessment, including CP-specific tools, quantitative sensory testing (QST), and the emerging use of wearable devices.

Recent Findings

Unidimensional pain assessment tools are constrained in capturing the multifaceted nature of CP pain. CP-specific tools, such as the Comprehensive Pain Assessment Tool (COMPAT) and its briefer variant, COMPAT-SF, exhibit promise but may necessitate further validation for broader adoption. QST provides a semi-objective method for characterizing pain profiles, and the P-QST consortium is refining QST for CP patients.
Additionally, technology is opening new avenues for objective pain assessment. Wearable devices, like smartwatches, can monitor vital signs, activity levels, and sleep quality. While they hold promise for improving pain assessment, their effectiveness requires further validation.

Summary

Accurate pain assessment is critical for managing CP. Recent developments include tools like COMPAT and COMPAT-SF, QST for characterizing pain profiles, and the potential of wearable devices. These advances can potentially enhance pain assessment and guide personalized treatment strategies. Integration into clinical practice and rigorous validation will be instrumental in improving CP pain assessment and raising the level of patient care.
Literatur
1.
Zurück zum Zitat Mullady DK, Yadav D, Amann ST, O’Connell MR, Barmada MM, Elta GH, et al. Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study. Gut. 2011;60:77–84.CrossRefPubMed Mullady DK, Yadav D, Amann ST, O’Connell MR, Barmada MM, Elta GH, et al. Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study. Gut. 2011;60:77–84.CrossRefPubMed
2.
Zurück zum Zitat Olesen SS, Juel J, Nielsen AK, Frøkjær JB, Wilder-Smith OHG, Drewes AM. Pain severity reduces life quality in chronic pancreatitis: implications for design of future outcome trials. Pancreatology. 2014;14:497–502.CrossRefPubMed Olesen SS, Juel J, Nielsen AK, Frøkjær JB, Wilder-Smith OHG, Drewes AM. Pain severity reduces life quality in chronic pancreatitis: implications for design of future outcome trials. Pancreatology. 2014;14:497–502.CrossRefPubMed
3.
Zurück zum Zitat Kuhlmann L, Olesen SS, Olesen AE, Arendt-Nielsen L, Drewes AM. Mechanism-based pain management in chronic pancreatitis – is it time for a paradigm shift? Expert Rev Clin Pharmacol. 2019;12:1–10.CrossRef Kuhlmann L, Olesen SS, Olesen AE, Arendt-Nielsen L, Drewes AM. Mechanism-based pain management in chronic pancreatitis – is it time for a paradigm shift? Expert Rev Clin Pharmacol. 2019;12:1–10.CrossRef
4.
Zurück zum Zitat Poulsen JL, Olesen SS, Malver LP, Frøkjær JB, Drewes AM. Pain and chronic pancreatitis: a complex interplay of multiple mechanisms. World J Gastroenterol. 2013;19:7282–91.CrossRefPubMedPubMedCentral Poulsen JL, Olesen SS, Malver LP, Frøkjær JB, Drewes AM. Pain and chronic pancreatitis: a complex interplay of multiple mechanisms. World J Gastroenterol. 2013;19:7282–91.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161:1976–82. Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161:1976–82. 
6.
Zurück zum Zitat Teo K, Johnson MH, Truter S, Pandanaboyana S, Windsor JA. Pain assessment in chronic pancreatitis: a comparative review of methods. Pancreatology. 2016;16:931–9.CrossRefPubMed Teo K, Johnson MH, Truter S, Pandanaboyana S, Windsor JA. Pain assessment in chronic pancreatitis: a comparative review of methods. Pancreatology. 2016;16:931–9.CrossRefPubMed
7.
Zurück zum Zitat •• Kuhlmann L, Teo K, Olesen SS, Phillips AE, Faghih M, Tuck N, et al. Development of the comprehensive pain assessment tool short form for chronic pancreatitis: validity and reliability testing. Clin Gastroenterol Hepatol [Internet]. 2022 [cited 2021 Oct 3];20:e770–83. Available from: https://pubmed.ncbi.nlm.nih.gov/34089847/. Accessed 30 Sept 2023. (This article addresses the validation of the first pancreas-specific pain assessment questionnaire and provides the possibility of thoroughly evaluating pain in CP using a questionnaire.) •• Kuhlmann L, Teo K, Olesen SS, Phillips AE, Faghih M, Tuck N, et al. Development of the comprehensive pain assessment tool short form for chronic pancreatitis: validity and reliability testing. Clin Gastroenterol Hepatol [Internet]. 2022 [cited 2021 Oct 3];20:e770–83. Available from: https://​pubmed.​ncbi.​nlm.​nih.​gov/​34089847/​. Accessed 30 Sept 2023. (This article addresses the validation of the first pancreas-specific pain assessment questionnaire and provides the possibility of thoroughly evaluating pain in CP using a questionnaire.)
8.
Zurück zum Zitat Teo K, Johnson MH, Drewes AM, Windsor JA. A comprehensive pain assessment tool (COMPAT) for chronic pancreatitis: development, face validation and pilot evaluation. Pancreatology. 2017;17:706–19.CrossRefPubMed Teo K, Johnson MH, Drewes AM, Windsor JA. A comprehensive pain assessment tool (COMPAT) for chronic pancreatitis: development, face validation and pilot evaluation. Pancreatology. 2017;17:706–19.CrossRefPubMed
9.
Zurück zum Zitat Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Breivik Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Breivik Hals EK, et al. Assessment of pain. Br J Anaesth.  2008;101:17–24.
10.
Zurück zum Zitat Kuhlmann L, Olesen SS, Drewes AM. Assessment of visceral pain with special reference to chronic pancreatitis. Front Pain Res. 2022;3:214.CrossRef Kuhlmann L, Olesen SS, Drewes AM. Assessment of visceral pain with special reference to chronic pancreatitis. Front Pain Res. 2022;3:214.CrossRef
11.
Zurück zum Zitat Kaiser U, Kopkow C, Deckert S, Neustadt K, Jacobi L, Cameron P, et al. Developing a core outcome domain set to assessing effectiveness of interdisciplinary multimodal pain therapy: the VAPAIN consensus statement on core outcome domains. Pain [Internet]. 2018 [cited 2021 Jan 1];159:673–83. Available from: https://www.painjournalonline.com673. Accessed 30 Sept 2023. Kaiser U, Kopkow C, Deckert S, Neustadt K, Jacobi L, Cameron P, et al. Developing a core outcome domain set to assessing effectiveness of interdisciplinary multimodal pain therapy: the VAPAIN consensus statement on core outcome domains. Pain [Internet]. 2018 [cited 2021 Jan 1];159:673–83. Available from: https://​www.​painjournalonlin​e.​com673. Accessed 30 Sept 2023.
12.
Zurück zum Zitat Smith SM, Dworkin RH, Turk DC, Baron R, Polydefkis M, Tracey I, et al. The Potential Role of Sensory Testing, Skin Biopsy, and Functional Brain Imaging as Biomarkers in Chronic Pain Clinical Trials: IMMPACT Considerations. J Pain [Internet]. 2017 [cited 2022 Oct 8];18:757–77. Available from: https://www.jpain.organdwww.sciencedirect.com Smith SM, Dworkin RH, Turk DC, Baron R, Polydefkis M, Tracey I, et al. The Potential Role of Sensory Testing, Skin Biopsy, and Functional Brain Imaging as Biomarkers in Chronic Pain Clinical Trials: IMMPACT Considerations. J Pain [Internet]. 2017 [cited 2022 Oct 8];18:757–77. Available from: https://​www.​jpain.​organdwww.​sciencedirect.​com
13.
Zurück zum Zitat Bloechle C, Izbicki JR, Knoefel WT, Kuechler T, Broelsch CE. Quality of life in chronic pancreatitis, results after duodenum-preserving resection of the head of the pancreas. Pancreas. 1995;11:77–85.CrossRefPubMed Bloechle C, Izbicki JR, Knoefel WT, Kuechler T, Broelsch CE. Quality of life in chronic pancreatitis, results after duodenum-preserving resection of the head of the pancreas. Pancreas. 1995;11:77–85.CrossRefPubMed
16.
Zurück zum Zitat •• Drewes AM, Bellin MD, Besselink MG, Bouwense SA, Olesen SS, van Santvoort H, et al. Assessment of pain associated with chronic pancreatitis: an international consensus guideline. Pancreatology. 2021;21:1256–84. (This article presents an international consensus and guideline on how to assess pain in chronic pancreatitis. This reference is key knowledge when trying to improve pain assessment in CP.)CrossRefPubMed •• Drewes AM, Bellin MD, Besselink MG, Bouwense SA, Olesen SS, van Santvoort H, et al. Assessment of pain associated with chronic pancreatitis: an international consensus guideline. Pancreatology. 2021;21:1256–84. (This article presents an international consensus and guideline on how to assess pain in chronic pancreatitis. This reference is key knowledge when trying to improve pain assessment in CP.)CrossRefPubMed
17.
Zurück zum Zitat Kumar P, Tripathi L. Challenges in pain assessment: pain intensity scales. Indian J Pain. 2014;28:61.CrossRef Kumar P, Tripathi L. Challenges in pain assessment: pain intensity scales. Indian J Pain. 2014;28:61.CrossRef
19.
Zurück zum Zitat Hadjistavropoulos T, Craig KD. A theoretical framework for understanding self-report and observational measures of pain: a communications model. Behav Res Ther [Internet]. 2002 [cited 2023 Aug 29];40:551–70. Available from: https://www.elsevier.com/locate/brat. Accessed 30 Sept 2023. Hadjistavropoulos T, Craig KD. A theoretical framework for understanding self-report and observational measures of pain: a communications model. Behav Res Ther [Internet]. 2002 [cited 2023 Aug 29];40:551–70. Available from: https://​www.​elsevier.​com/​locate/​brat. Accessed 30 Sept 2023.
20.
Zurück zum Zitat Robinson ME, Myers CD, Sadler IJ, Riley JL, Kvaal SA, Geisser ME. Bias effects in three common self-report pain assessment measures. Clin J Pain. 1997;13:74–81.CrossRefPubMed Robinson ME, Myers CD, Sadler IJ, Riley JL, Kvaal SA, Geisser ME. Bias effects in three common self-report pain assessment measures. Clin J Pain. 1997;13:74–81.CrossRefPubMed
21.
Zurück zum Zitat Palsson TS, Christensen SWM, De Martino E, Graven-Nielsen T. Pain and disability in low back pain can be reduced despite no significant improvements in mechanistic pain biomarkers. Clin J Pain. 2021;37:330–8.CrossRefPubMed Palsson TS, Christensen SWM, De Martino E, Graven-Nielsen T. Pain and disability in low back pain can be reduced despite no significant improvements in mechanistic pain biomarkers. Clin J Pain. 2021;37:330–8.CrossRefPubMed
22.
Zurück zum Zitat Yadav D, Palermo TM, Phillips AE, Bellin MD, Conwell DL. Painful chronic pancreatitis - new approaches for evaluation and management. Curr Opin Gastroenterol. 2021;37:504–11.CrossRefPubMedPubMedCentral Yadav D, Palermo TM, Phillips AE, Bellin MD, Conwell DL. Painful chronic pancreatitis - new approaches for evaluation and management. Curr Opin Gastroenterol. 2021;37:504–11.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Nijs J, George SZ, Clauw DJ, Fernández-de-las-Peñas C, Kosek E, Ickmans K, et al. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. Lancet Rheumatol. 2021;3:e383–92.CrossRefPubMed Nijs J, George SZ, Clauw DJ, Fernández-de-las-Peñas C, Kosek E, Ickmans K, et al. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. Lancet Rheumatol. 2021;3:e383–92.CrossRefPubMed
25.
Zurück zum Zitat •• Phillips AE, Faghih M, Kuhlmann L, Larsen IM, Drewes AM, Singh VK, et al. A clinically feasible method for the assessment and characterization of pain in patients with chronic pancreatitis: pain phenotyping in chronic pancreatitis. Pancreatology. 2020;20:25–34. (The P-QST consortium presents the bedside QST regimen that can be used to evaluate pain profiles in CP.)CrossRefPubMed •• Phillips AE, Faghih M, Kuhlmann L, Larsen IM, Drewes AM, Singh VK, et al. A clinically feasible method for the assessment and characterization of pain in patients with chronic pancreatitis: pain phenotyping in chronic pancreatitis. Pancreatology. 2020;20:25–34. (The P-QST consortium presents the bedside QST regimen that can be used to evaluate pain profiles in CP.)CrossRefPubMed
26.
Zurück zum Zitat Smith SM, Dworkin RH, Turk DC, Baron R, Polydefkis M, Tracey I, et al. The potential role of sensory testing, skin biopsy, and functional brain imaging as biomarkers in chronic pain clinical trials: IMMPACT considerations. J Pain. 2017;18:757–77.CrossRefPubMedPubMedCentral Smith SM, Dworkin RH, Turk DC, Baron R, Polydefkis M, Tracey I, et al. The potential role of sensory testing, skin biopsy, and functional brain imaging as biomarkers in chronic pain clinical trials: IMMPACT considerations. J Pain. 2017;18:757–77.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Linde LD, Duarte FCK, Esmaeili H, Hamad A, Masani K, Kumbhare DA. The nociceptive flexion reflex: a scoping review and proposed standardized methodology for acquisition in those affected by chronic pain. Br J Pain. 2021;15:102–13.CrossRefPubMed Linde LD, Duarte FCK, Esmaeili H, Hamad A, Masani K, Kumbhare DA. The nociceptive flexion reflex: a scoping review and proposed standardized methodology for acquisition in those affected by chronic pain. Br J Pain. 2021;15:102–13.CrossRefPubMed
32.
Zurück zum Zitat Liao D, Nedergaard RB, Unnisa M, Mahapatra SJ, Faghih M, Phillips AE, Yadav D, Singh VK, Olesen SS, Talukdar R, et al. Electrocardiography assessment of sympatico–vagal balance during resting and pain using the texas instruments ADS1299. Bioengineering 2023;10:205. https://doi.org/10.3390/bioengineering10020205 Liao D, Nedergaard RB, Unnisa M, Mahapatra SJ, Faghih M, Phillips AE, Yadav D, Singh VK, Olesen SS, Talukdar R, et al. Electrocardiography assessment of sympatico–vagal balance during resting and pain using the texas instruments ADS1299. Bioengineering 2023;10:205. https://​doi.​org/​10.​3390/​bioengineering10​020205
33.
Zurück zum Zitat • Leroux A, Rzasa-Lynn R, Crainiceanu C, Sharma T. Wearable devices: current status and opportunities in pain assessment and management. Digit Biomark. 2021;5:89–102. (These articles present the possible future in pain assessment, including in CP. The validity in CP, however, remains to be examined.)CrossRefPubMedPubMedCentral • Leroux A, Rzasa-Lynn R, Crainiceanu C, Sharma T. Wearable devices: current status and opportunities in pain assessment and management. Digit Biomark. 2021;5:89–102. (These articles present the possible future in pain assessment, including in CP. The validity in CP, however, remains to be examined.)CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat • Hadjiat Y, Arendt-Nielsen L. Digital health in pain assessment, diagnosis, and management: overview and perspectives. Front Pain Res. 2023;4:1097379. https://doi.org/10.3389/fpain.2023.1097379(These articles present the possible future in pain assessment, including in CP. The validity in CP, however, remains to be examined.) • Hadjiat Y, Arendt-Nielsen L. Digital health in pain assessment, diagnosis, and management: overview and perspectives. Front Pain Res. 2023;4:1097379. https://​doi.​org/​10.​3389/​fpain.​2023.​1097379(These articles present the possible future in pain assessment, including in CP. The validity in CP, however, remains to be examined.)
35.
Zurück zum Zitat Bjelland I, Dahl AA, Haug T, Neckelmann D. The validity of the hospital anxiety and depression scale an updated literature review. J Psychosom Res. 2002;52:69–77.CrossRefPubMed Bjelland I, Dahl AA, Haug T, Neckelmann D. The validity of the hospital anxiety and depression scale an updated literature review. J Psychosom Res. 2002;52:69–77.CrossRefPubMed
36.
Zurück zum Zitat Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993;4:353–65.CrossRefPubMed Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993;4:353–65.CrossRefPubMed
37.
Zurück zum Zitat Lee PH, Macfarlane DJ, Lam T, Stewart SM. Validity of the international physical activity questionnaire short form. Int J Behav Nutr Phys Act. 2011;8:1–11. Lee PH, Macfarlane DJ, Lam T, Stewart SM. Validity of the international physical activity questionnaire short form. Int J Behav Nutr Phys Act. 2011;8:1–11.
38.
Zurück zum Zitat Osman A, Barrios FX, Gutierrez PM, Kopper BA, Merrifield T, Grittmann L. The pain catastrophizing scale: further psychometric evaluation with adult samples. J Behav Med. 2000;23:351–65.CrossRefPubMed Osman A, Barrios FX, Gutierrez PM, Kopper BA, Merrifield T, Grittmann L. The pain catastrophizing scale: further psychometric evaluation with adult samples. J Behav Med. 2000;23:351–65.CrossRefPubMed
39.
Zurück zum Zitat Fayers P, Bottomley A. Quality of life research within the EORTC - the EORTC QLQ-C30. Eur J Cancer. 2002;38:125–33.CrossRef Fayers P, Bottomley A. Quality of life research within the EORTC - the EORTC QLQ-C30. Eur J Cancer. 2002;38:125–33.CrossRef
40.
Zurück zum Zitat Bishop A. Pain Attitudes and Beliefs Scale ( PABS ) The illness perceptions questionnaire-revised ( IPQ-R ). J Physiother. 2010;56:279–80.CrossRefPubMed Bishop A. Pain Attitudes and Beliefs Scale ( PABS ) The illness perceptions questionnaire-revised ( IPQ-R ). J Physiother. 2010;56:279–80.CrossRefPubMed
42.
Zurück zum Zitat Langley GB, Sheppeard H. The visual analogue scale: its use in pain measurement. Rheumatol Int. 1985;5:145–8.CrossRefPubMed Langley GB, Sheppeard H. The visual analogue scale: its use in pain measurement. Rheumatol Int. 1985;5:145–8.CrossRefPubMed
44.
Zurück zum Zitat Reid GJ, Gilbert CA, Mcgrath PJ. The pain coping questionnaire: preliminary validation. Pain. 1998;76:83–96.CrossRefPubMed Reid GJ, Gilbert CA, Mcgrath PJ. The pain coping questionnaire: preliminary validation. Pain. 1998;76:83–96.CrossRefPubMed
45.
Zurück zum Zitat Goñi E, Madariaga JM, Axpe I, Goñi A. Structure of the personal self-concept ( PSC ). Int J Psychol Psychol Ther. 2011;11:509–22. Goñi E, Madariaga JM, Axpe I, Goñi A. Structure of the personal self-concept ( PSC ). Int J Psychol Psychol Ther. 2011;11:509–22.
46.
Zurück zum Zitat Carpenter JS, Andrykowski MA. Psychometric evaluation of the Pittsburgh sleep quality index. J Psychosom Res. 1998;45:5–13.CrossRefPubMed Carpenter JS, Andrykowski MA. Psychometric evaluation of the Pittsburgh sleep quality index. J Psychosom Res. 1998;45:5–13.CrossRefPubMed
Metadaten
Titel
Tools for Bedsite Pain Assessments in Chronic Pancreatitis
verfasst von
Louise Kuhlmann, MD, PhD
Asbjørn Mohr Drewes, MD, PhD, DMSc
Publikationsdatum
03.04.2024
Verlag
Springer US
Erschienen in
Current Treatment Options in Gastroenterology
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-024-00445-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.