Outcomes prioritized by the ASH guideline panel on management of acute and chronic pain
| Critical outcomes for decision making . |
|---|
| Q1. |
| No. of analgesic doses administered |
| Time to first analgesic dose |
| Time to second analgesic dose |
| Total MME administered |
| Rate of hospitalization |
| Proportion discharged home from the ED |
| Length of stay in ED |
| Proportion admitted to observation unit |
| Improved pain intensity defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Percentage of patients who achieve reduction in pain score back to baseline at disposition |
| Satisfaction with care |
| Rate of hypoxic events |
| Rate of naloxone administrations |
| Q2. |
| Total MME consumed |
| Improved pain intensity defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Length of stay |
| Time to reduction in pain intensity |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Acute functional outcome (Youth Acute Pain Functional Ability Questionnaire) |
| Patient satisfaction |
| Opioid-related adverse effects |
| PGIC |
| CGIC |
| Q3. |
| Improved pain intensity, defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Pain coping strategies (eg, negative thinking, stress) |
| Total MME consumed |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Length of stay |
| Return to baseline pain |
| Q4. |
| Wait times for care |
| Time to first analgesic dose |
| Time between analgesic doses |
| Need for ED care |
| Hospitalizations |
| Missed school/work days |
| Improved pain intensity, defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Cost |
| Patient satisfaction with care |
| Q5. |
| Improved pain intensity, defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Length of stay |
| Time to reduction in pain intensity |
| Patient satisfaction with care |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Acute functional outcome (Youth Acute Pain Functional Ability questionnaire) |
| Total opioid consumed in a 24-h period (ie, either oral or parenteral milligram opioid equivalents) |
| PGIC |
| CGIC |
| Rate of respiratory depression events |
| Rate of hypoxic events |
| Rate of naloxone administrations |
| Rate of acute chest events |
| Q6. |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| Reduction in chronic opioids (daily dose of MME) |
| Pain intensity |
| PGIC |
| CGIC |
| Q7. |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| Reduction in chronic opioids (daily dose of MME) |
| Pain intensity |
| PGIC |
| CGIC |
| Q8. |
| Pain intensity |
| Pain coping strategies (eg, negative thinking, stress) |
| Reduction in chronic opioids (daily dose of MME) |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| PGIC |
| CGIC |
| Q9. |
| Long-term benefit (pain relief) |
| Long-term harm (defined broadly) |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Opioid-induced hyperalgesia |
| Health care encounters for pain |
| Hospitalization rate |
| Sleep |
| Mood (anxiety, depression) |
| Q10. |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| Reduction in chronic opioids (daily dose of MME) |
| Pain intensity |
| PGIC |
| CGIC |
| Critical outcomes for decision making . |
|---|
| Q1. |
| No. of analgesic doses administered |
| Time to first analgesic dose |
| Time to second analgesic dose |
| Total MME administered |
| Rate of hospitalization |
| Proportion discharged home from the ED |
| Length of stay in ED |
| Proportion admitted to observation unit |
| Improved pain intensity defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Percentage of patients who achieve reduction in pain score back to baseline at disposition |
| Satisfaction with care |
| Rate of hypoxic events |
| Rate of naloxone administrations |
| Q2. |
| Total MME consumed |
| Improved pain intensity defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Length of stay |
| Time to reduction in pain intensity |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Acute functional outcome (Youth Acute Pain Functional Ability Questionnaire) |
| Patient satisfaction |
| Opioid-related adverse effects |
| PGIC |
| CGIC |
| Q3. |
| Improved pain intensity, defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Pain coping strategies (eg, negative thinking, stress) |
| Total MME consumed |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Length of stay |
| Return to baseline pain |
| Q4. |
| Wait times for care |
| Time to first analgesic dose |
| Time between analgesic doses |
| Need for ED care |
| Hospitalizations |
| Missed school/work days |
| Improved pain intensity, defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Cost |
| Patient satisfaction with care |
| Q5. |
| Improved pain intensity, defined as percentage of patients who achieve ≥30% reduction in pain score or ≥2-point reduction in pain score on a standard NRS or ≥20-mm reduction in VAS score from first score to last score |
| Length of stay |
| Time to reduction in pain intensity |
| Patient satisfaction with care |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Acute functional outcome (Youth Acute Pain Functional Ability questionnaire) |
| Total opioid consumed in a 24-h period (ie, either oral or parenteral milligram opioid equivalents) |
| PGIC |
| CGIC |
| Rate of respiratory depression events |
| Rate of hypoxic events |
| Rate of naloxone administrations |
| Rate of acute chest events |
| Q6. |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| Reduction in chronic opioids (daily dose of MME) |
| Pain intensity |
| PGIC |
| CGIC |
| Q7. |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| Reduction in chronic opioids (daily dose of MME) |
| Pain intensity |
| PGIC |
| CGIC |
| Q8. |
| Pain intensity |
| Pain coping strategies (eg, negative thinking, stress) |
| Reduction in chronic opioids (daily dose of MME) |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| PGIC |
| CGIC |
| Q9. |
| Long-term benefit (pain relief) |
| Long-term harm (defined broadly) |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Opioid-induced hyperalgesia |
| Health care encounters for pain |
| Hospitalization rate |
| Sleep |
| Mood (anxiety, depression) |
| Q10. |
| Health care encounters for pain |
| HRQOL (general domains and pain-specific domains, including pain interference and pain behavior) |
| Functional outcomes |
| Sleep |
| Mood (anxiety, depression) |
| Reduction in chronic opioids (daily dose of MME) |
| Pain intensity |
| PGIC |
| CGIC |
CFIC, clinician global impression of change; NRS, numerical rating scale; PGIC, patient global impression of change; VAS, visual analogue scale.