Brief Pain Inventory Interference Scale Research Articles

Measuring the interference of pain on daily life in persons with spinal cord injury: A Rasch-validated subset of items from the Brief Pain Inventory interference scale.

Up to 60% of individuals report chronic pain after traumatic spinal cord injury (SCI). Measurement of the degree to which pain interferes with activities and emotions can provide valuable clinical insights with implications for pain management interventions. One questionnaire that can be used to quantify the impact of pain is the Brief Pain Inventory (BPI) interference scale, a seven-item self-report assessment. Our objective was to examine the Rasch measurement properties of the BPI interference scale for measuring pain interference in persons with SCI. A secondary analysis of cross-sectional, population-based, self-report data was conducted. Participants were adults with traumatic SCI with residual effects who were at least one year post-injury and 18years of age (n=876). Rasch analysis was used to evaluate the measurement properties of the BPI interference items for persons with SCI. Two BPI interference scale items were excluded from analysis due to high rates of missing data. Of the remaining five items, four items demonstrated acceptable measurement properties in the SCI population. Four of the original seven BPI interference items provide acceptable measurements of pain interference in the SCI population.

Abstract P1-13-01: Comparing the Effects of Denosumab and Zoledronic Acid on Pain Interference with Daily Functioning in a Randomized Phase 3 Trial of Patients with Breast Cancer and Bone Metastases

Abstract In a recently completed trial of breast cancer patients with bone metastases, denosumab, a fully human monoclonal anti-RANKL antibody, was superior to zoledronic acid (ZA) in delaying/preventing skeletal-related events. Between-treatment differences in patient-reported pain interference with daily functioning were assessed. Eligible breast cancer patients received monthly subcutaneous denosumab 120 mg or intravenous ZA 4 mg (double-bind, double-dummy design). Patients completed the Brief Pain Inventory (BPI) to assess pain severity and interference with daily functioning (range 0 [does not interfere]-10 [interferes completely]) at baseline (BL), day 8, and before each monthly visit through end of study. The BPI interference scale generated a total interference score as well as an activity subscale (interference with walking, general activity, and work) and an affective subscale (interference with relations with others, enjoyment of life, and mood). Analyses were conducted on all randomized patients with ≥1 PRO assessment and were performed through week 73, when 30% of patients had dropped out due to death, disease progression, or consent withdrawal. Subgroups included patients with no/mild and moderate/severe worst pain at BL. Analyses included time to improvement (≥2-point decrease) or worsening (≥2-point increase) in pain interference, mean change from baseline, and proportion of patients with improving or worsening pain interference scores. Time to improvement in pain interference with activity (PIWA) tended to occur more quickly with denosumab compared with ZA (N=1124; median: 70 days denosumab v 86 days ZA; P=0.09), and time to worsening PIWA tended to be longer with denosumab compared with ZA (N=1676; median: 394 days denosumab v 310 days ZA; P=0.13). In patients with no/mild pain at BL, denosumab also demonstrated a trend for shorter time to improvement in PIWA (N=388; 93 days denosumab v 120 days ZA; P=0.06) and longer time to worsening PIWA (N=755; 369 days denosumab v 232 days ZA; P=0.12). Overall, a greater proportion of patients on denosumab had improvement in PIWA on study than ZA (Figure). Findings were similar with the total interference score and affective subscale. Figure Proportion of Patients With Improvement in Pain Interference With Activity (≥2-point decrease from BL)* Daily functioning (total interference and interference with activity and affect) tended to be less disrupted by pain in patients on denosumab compared with ZA. Decreased pain interference showed a trend to occur more quickly with denosumab. Overall, a greater proportion of denosumab patients reported decreased pain interference than ZA patients. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-13-01.

Can cancer patients assess the influence of pain on functions? A randomised, controlled study of the pain interference items in the Brief Pain Inventory

BackgroundThe Brief Pain Inventory (BPI) is recommended as a pain measurement tool by the Expert Working Group of the European Association of Palliative Care. The BPI is designed to assess both pain severity and interference with functions caused by pain. The purpose of this study was to investigate if pain interference items are influenced by other factors than pain.MethodsWe asked adult cancer patients to complete the original and a revised BPI on two study days. In the original version of the BPI the patients were asked how, during the last 24 hours, pain has interfered with functions. In the revised BPI this question was changed to how, during the last 24 hours, these functions are affected in general. Heath related quality of life was assessed at both study days applying the European Organization for Research and Treatment of Cancer quality of life questionnaire.ResultsForty-eight of the 55 included patients completed both assessments. The BPI pain intensities scores and the health related quality of life scores were similar at the two study days. Except for mood this study observed no significant distinctions between the patients' BPI interference items scores in the original (pain influence on function) and the revised BPI (function in general). Seventeen patients reported higher influence from pain on functions than the total influence on function from all causes.ConclusionWe observed similar scores in the original BPI interference scores (pain influence on function) compared with the revised BPI interference scores (decreased function in general). This finding might imply that the BPI interference scale measures are partly responded to as more of a global interference measure.

The Reliability and Validity of Pain Interference Measures in Persons with Multiple Sclerosis

Valid measures of pain-related interference with functioning could serve as useful outcome measures in much needed clinical trials of pain treatments for persons with multiple sclerosis (MS). The purpose of this study was to examine the psychometric properties of two pain interference measures in persons with MS and chronic pain. Modified versions of the Interference scale of the Brief Pain Inventory (BPI) and the Disability scale of the Graded Chronic Pain Scale were administered via a mailed survey to 187 community-dwelling persons with MS. Data from the 125 participants who reported pain were analyzed. Although both measures demonstrated excellent internal consistency, in the current sample, evidence regarding the construct and concurrent validity was stronger for the modified versions of the BPI Interference scale. These results provide preliminary support for the reliability and validity of modified versions of the BPI Interference scale in persons with MS and chronic pain.

The Reliability and Validity of Pain Interference Measures in Persons With Spinal Cord Injury

The current study compared the psychometric properties of 2 commonly used measures of pain-related interference, the Graded Chronic Pain (GCP) Disability scale and 3 modified versions of the Brief Pain Inventory (BPI) Interference scale. Participants were 127 persons with spinal cord injury (SCI) who reported pain on a survey. The results suggest that the GCP Disability scale and 3 versions of the BPI Interference scale are reliable and valid measures of pain-related interference in persons with SCI and pain. All 4 measures evidenced excellent internal consistency. The composite scores and individual items of the GCP Disability scale and each version of the BPI Interference scale were significantly related to average pain intensity during the past week and a global measure of psychological functioning. Finally, as pain intensity ratings increased (from mild to moderate to severe), so did the composite and item-level ratings of interference for each version of the BPI Interference scale and GCP Disability scale. Strengths and weaknesses of each measure for use with persons with disability and pain are discussed. Perspective The GCP Disability scale and 3 versions of the BPI Interference scale (modified for use in persons with disabilities) appear to be reliable and valid measures of pain-related interference in persons with SCI. Future research should examine their psychometric properties in other disability populations.