Tools in this Module
Pain Assessment
Iowa Pain Thermometer-Revised
Moderate evidence.
Source: Used with permission Keela Herr, PhD, RN, AGSF, FAAN, College of Nursing, The University of Iowa, Iowa City, IA, USA
Multidimensional Pain Measure
PEG: Pain, Enjoyment, General Activity
Moderate evidence.
Source: Krebs, et al, 2009
Opioid Risk Tool (ORT)
Moderate evidence.
Assess risk of aberrant behaviors when patients are prescribed opioids for chronic pain
10 item questionnaire in 5 domains; scores are different for males and females.
Score range: 0 to 26
- Low Risk 0-3
- Moderate Risk 4-7
- High Risk >7
General Anxiety Disorder (GAD7)
- Cognition Assessment
- Mini-Mental State Exam (MMSE)
Moderate evidence.
- Self report scale for assessing generalized anxiety disorder
- 7 item questionnaire
- Likert scale 0 to 3 with anchors of 0= Not at all and 3=Nearly every day
- Total score range 0-21
Functional Assessment
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Moderate evidence.
- Knee specific instrument for patient reported outcomes
- Takes 10-15 minutes to complete
- 42 items in 5 subscales: pain, other symptoms, function in daily living, function in sport and recreation and knee-related quality of life
- Each question scored from 0 (no problems) to 4 (extreme problems)
- Scores for each subscale is transformed to a 0-100 scale with 0 representing extreme problems and 100 representing no problems
Cognition
Mini-Mental State Examination (MMSE)
Moderate evidence.
- 30 point questionnaire to measure cognitive impairment
- Takes 5-10 minutes to complete
- Assessment of attention, recall, language, ability to follow simple commands and orientation
- Score of 24 or greater is considered normal cognition
Acknowledgements
PI
Keela Herr, PhD, RN, AGSF, FGSA, FAAN
Co-PI
Kathleen Sluka, PhD, PT
Project Coordinator
Eiko Oka, MPH
Case Developers Team
- Dana Dailey, PhD, PT (Lead)
- Barbara St. Marie, PhD, ANP, GNP
- Sara Sanders, PhD, MSW
- John Swegle, PharmD
- Valerie Keffala, PhD
- Nicolas O Noiseux, MD, MS, FRCS
Instructional Design Team
- Nor Hashidah Abd Hamid, PhD (Instructional Designer)
- Laurie Walkner, MA, BSN (Instructional Design Coordinator)
- Melissa Richlen, BA (Media Specialist)
Actors
- Richard Beebe as Donald Williams
- Carol Vance as Physical Therapist
- Dana Dailey as Occupational Therapist
Narrator
- Dana Dailey
- Pharmacist's voice: Melissa Richlen
- Reviewers (University of Iowa):
- Carol Gorney, MPAS, PA-C
- Anne Smith, RN
- Anthony Brenneman, MPAS
A special thanks to Oaknoll Retirement Residence, Iowa City, Iowa, for providing spaces for video recording.
References
- Braekhus, A.p., K.p. Laake, and K.p. Engedal, The Mini-Mental State Examination: identifying the most efficient variables for\par detecting cognitive impairment in the elderly.\par. J Am Geriatr Soc\par, 1992. 40\par(11\par): p. 1139-45\par.
- Herr, K.A. and L. Garand, Assessment and measurement of pain in older adults. Clin Geriatr Med, 2001. 17(3): p. 457-78, vi.
- Krebs, E.E., et al., Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med, 2009. 24(6): p. 733-8.
- Rakel BA, Blodgett NP, Bridget Zimmerman M, Logsden-Sackett N, Clark C, Noiseux N, Callaghan J, Herr K, Geasland K, Yang X et al: Predictors of postoperative movement and resting pain following total knee replacement. Pain 2012.
- Roos, E.M.p. and S.p. Toksvig-Larsen, Knee injury and Osteoarthritis Outcome Score (KOOS) - validation and comparison\par to the WOMAC in total knee replacement.\par. Health Qual Life Outcomes\par, 2003. 1\par: p. 17\par.
- Spitzer, R.L.p., et al., A brief measure for assessing generalized anxiety disorder: the GAD-7.\par. Arch Intern Med\par, 2006. 166\par(10\par): p. 1092-7\par.
- Webster, L.R.p. and R.M.p. Webster, Predicting aberrant behaviors in opioid-treated patients: preliminary validation \par of the Opioid Risk Tool.\par. Pain Med\par, 2005. 6\par(6\par): p. 432-42\par.
- Total Knee Arthroplasty: http://www.mayoclinic.org/tests-procedures/knee-replacement/basics/defi…
- Home Safety: Center for Disease Control https://www.cdc.gov/steadi/patient.html1.
- American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc, 2015. 63(11): p. 2227-46.
- Braekhus, A.p., K.p. Laake, and K.p. Engedal, The Mini-Mental State Examination: identifying the most efficient variables for\par detecting cognitive impairment in the elderly.\par. J Am Geriatr Soc\par, 1992. 40\par(11\par): p. 1139-45\par.
- Chou, R., et al., Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Annals of Internal Medicine, 2007. 147(7): p. 505.