Brief Pain Inventory (BPI)

Description of the Brief Pain Inventory (BPI)
The Brief Pain Inventory (BPI), based from a measure known as the Wisconsin Brief Pain Questionnaire, was developed by the Pain Research Group to provide information on the intensity of pain (the sensory dimension) as well as the degree to which pain interferes with function (the reactive dimension). The BPI also asks questions about pain relief, pain quality, and the patient's perception of the cause of pain.

The BPI uses 0 to 10 numeric rating scales (NRS) for item rating because of its simplicity, lack of ambiguity and seemed the best to use for cross-linguistic pain measurement. Since pain can be quite variable over a day, the BPI asks patients to rate their pain at the time of responding to the questionnaire (pain now), and also at its worst, least, and average over the previous week. The ratings can also be made for the last 24 hours. The design of the study will dictate the most appropriate period to rate. The pain worst rating can be chosen to be the primary response variable, with the other items serving as a check on variability, or, alternatively, these ratings can be combined to give a composite index of pain severity. While it is necessary to limit the dimensions of assessment, it is critical to estimate the degree to which pain limits patient function. Interference of function can be thought of as a reactive dimension. An effective intervention for pain control should demonstrate its effectiveness on more than a reduction in pain intensity alone. Again, using numeric 0 to 10 scales, with 0 being "no interference" and 10 being "interferes completely," the BPI asks for ratings of the degree to which pain interferes with mood, walking and other physical activity, work, social activity, relations with others, and sleep. The mean of these scores can be used as a pain interference score.

The BPI has demonstrated respectable test-retest item correlations (reliability), at least over short intervals. Evidence for the validity of the BPI comes from several studies using the instrument with cancer patients and patients with other diseases who had pain. Expected differences in pain severity were found between groups of patients with pain who differed in the presence or absence of metastases. Ratings of pain interference with various activities increased as ratings of pain severity were higher. The proportion of patients receiving opioid analgesics increased with increased severity rating. Finally, the correlations among the items differed in a logical way from one disease to another, suggesting that the BPI is sensitive to differences in pain characteristics associated with different diseases.

A unique feature of the BPI is that it has been validated in many languages such as Chinese, Filipino, French, Hindi, Italian, Spanish and Vietnamese, and has been shown to produce similar data from patients in these countries and from many different cultures. Finally, the BPI has several applications, including studies of the epidemiology of cancer pain, the routine clinical assessment of pain, efforts to assure the quality of pain management, and the conduct of clinical trials examining the effectiveness of cancer pain treatments. ^[2]

The Patient Survey Process
It is recommended that patients are surveyed according to the Minimum Recommended Schedule of Assessments. It will be important to keep track of when your patient was last surveyed so you will know when they are due for their next survey.

Please be sure the patient is fluent in reading the language used in the survey. If not, do not proceed with administering the survey. The translations are available in the Fabry Registry Materials Section. If the language is not listed please contact the Fabry Registry staff to see if there is a translated survey available in the patient’s native language.

• Download Brief Pain Inventory (Short Form) (PDF)

The self-administered surveys may be conducted when the patient is in the clinic/office or through the mail. If conducted in the clinical setting, then administer the survey before the patient sees the physician or is asked about other health questions to avoid potentially influencing the patient’s answers.

For patients who cannot complete the form themselves, interview the patient reading all questions as written and slowly enough for him or her to consider each statement and respond. Record responses, but avoid extended discussions of the question or response.

After the patient has completed the survey, check to be sure that all questions have been answered, and that only one answer has been provided to each question. If a response is incomplete or unclear, ask the patient to complete the question or clarify his or her choice. If the patient makes an error while completing the survey, the mark must be lined through or completely erased and the correct mark filled in and prominently noted.

For more information on performing Pain Assessments, please contact the Fabry Registry.

References

1. Adapted from the SF-36 Health Survey Manual & Interpretation Guide, by John E. Ware, Jr., Ph.D.

2. Referenced from http://www.qlmed.org/BPI/description.html