Use of the Brief Pain Inventory and Hospital Anxiety/Depression Scale questionnaires in a district general hospital pain clinic

Abstract

Introduction: A chronic pain database (PACS) was introduced at the Pain Management Clinic of University Hospital Lewisham (UHL) in July 2001. Each patient attending the outpatient clinic to see the Consultant or the Specialist Nurse was asked to complete the brief pain inventory (BPI) and the hospital anxiety and depression scale (HAD). We looked at the data of patients who had received the tricyclic antidepressant (TCA) amitriptyline as a part of a multi-treatment regime over a period of 4 years from August 2001 to July 2005. Material and Methods: We looked at the data of patients who were treated with amitriptyline in a 4-year period, starting from August 2001. We selected 124 patients on whom full information and follow up was available. In addition to treatment received we also looked at BPI pain score and HAD mood scores. Results: We found an average pain relief of 40.5% as assessed by BPI, with 72 out of 124 patients (40%) achieving at least 50% relief. We found that the two main outcomes of the BPI (percentage pain relief and change in interference score) showed a significant correlation. The HAD score did not correlate with pain relief. The extent of the use of other concurrent treatments showed no correlation with pain relief. The pain relief was not related to the TCA dose. Discussion: In our analysis, the combination of amitriptyline with other pain relief treatments produced a meaningful beneficial effect. It was not, however, possible to establish the individual contribution of the TCA.