Chronic Pain: A Case Application of a Novel Framework to Guide Interprofessional Assessment and Intervention in Primary Care

Figures & data

Figure 1. Radar plot generated for the patient using the clinical reasoning framework described by Walton and Elliott.⁶

Table 1. Baseline PROM scores with interpretation.

	Baseline score	Interpretation
BPI-SF	Mean pain severity = 7.3	Significant pain severity and interference; patient indicated 30% relief from pain treatments or medications
	Mean pain interference = 8.7
BIPQ	60/80	Higher scores indicate the illness is perceived as threatening
PCS	39	>30 indicates clinically relevant catastrophizing
DASS21	Depression = 16	Depression = moderate
	Anxiety = 8	Anxiety = mild
	Stress = 26	Stress = severe
CSI	56	>40 indicates likelihood of central sensitization; 56 considered severe
S-LANSS	19	>12 indicates pain of predominantly neuropathic origin
TSK	51	>37 indicates the likelihood of kinesiophobia

PROM: Patient-reported outcome measure; BPI-SF: Brief Pain Inventory Short Form; BIPQ: Brief Illness Perception Questionnaire; PCS: Pain Catastrophizing Scale; DASS21: Depression, Anxiety, and Stress Scale; CSI: Central Sensitization Inventory; S-LANSS: Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs; TSK: Tampa Scale for Kinesiophobia.

Table 2. Postintervention PROM scores with interpretation.

	Postintervention score (change from baseline)	MCID	Interpretation
BPI-SF	Mean pain severity = 4.5 (−2.8)	30%	Clinically important decrease in pain severity (38%) and pain interference (36%); patient indicated 60% relief from pain treatments or medications
	Mean pain interference = 5.6 (−3.1)
BIPQ	34/80 (−26)	—	Decrease in the perception of threat from the illness
PCS	8 (−31)	1.9–13.6	Clinically important decrease in catastrophizing
DASS21	Depression = 6 (−10)	—	Depression = normal
	Anxiety = 10 (+2)		Anxiety = moderate
	Stress = 12 (−14)		Stress = normal
CSI	33 (−23)	—	Decrease in central sensitization
TSK	36 (−15)	—	Decrease in fear of movement

PROM: Patient-reported outcome measure; MCID: minimal clinically important difference; BPI-SF: Brief Pain Inventory Short Form; BIPQ: Brief Illness Perception Questionnaire; PCS: Pain Catastrophizing Scale; DASS21: Depression, Anxiety, and Stress Scale; CSI: Central Sensitization Inventory; S-LANSS: Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs; TSK: Tampa Scale for Kinesiophobia.

Walton DM, Elliott JM. A new clinical model for facilitating the development of pattern recognition skills in clinical pain assessment. Musculoskelet Sci Pract. 2018;36:17–24. doi:10.1016/j.msksp.2018.03.006.

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