Scales and such

[epidural man]

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What scales do you use in your intakes? And do you find them useful?

Our patients have to fill out a lot of crap on their first visit. I'm wondering the utility.

They fill out a standard pain history, questionaire, ROS, and such, but also a Pain Disability Questionnaire, Oswestry, Neck Pain Disability Index Questionnaire (if there for neck pain), PCL for PTSD screening, PHQ-9 (depression screen), and the Sheehan Disability Scale (SDS).

Also, if you make them do a scale or two on the initial - what do you make them repeat on f/u?

 

[ghost dog]

What scales do you use in your intakes? And do you find them useful?

Our patients have to fill out a lot of crap on their first visit. I'm wondering the utility.

They fill out a standard pain history, questionaire, ROS, and such, but also a Pain Disability Questionnaire, Oswestry, Neck Pain Disability Index Questionnaire (if there for neck pain), PCL for PTSD screening, PHQ-9 (depression screen), and the Sheehan Disability Scale (SDS).

Also, if you make them do a scale or two on the initial - what do you make them repeat on f/u?

In regards to psych issues, I like PHQ-9's brother: the GAD-7. Quite useful.

The brief pain inventory is extremely useful: taking a quick glance at their pain diagram gives one a good snapshot of what may be going on.

As part of my clinic's protocol, I have pt's fill out a BPI at each subsequent visit. Specifically, this is more to do with monitoring opioids than anything else.
Depending on the type of pain a pt has, I will repeat interval Oswestry, NDI indices at 4-6 week intervals to evaluate progress.

I also manage co-morbid psych issues myself, and similiarly repeat the GAD-7 and PHQ-9 at similiar intervals, following the appropriate medications ( sadly, most of my pts can't afford psychotherapy).

Perhaps a bit controversial : I will sometimes use the Fear-Avoidance Beliefs questionnaire (FABQ) in some settings.

 

[Jcm800]

What scales do you use in your intakes? And do you find them useful?

Our patients have to fill out a lot of crap on their first visit. I'm wondering the utility.

They fill out a standard pain history, questionaire, ROS, and such, but also a Pain Disability Questionnaire, Oswestry, Neck Pain Disability Index Questionnaire (if there for neck pain), PCL for PTSD screening, PHQ-9 (depression screen), and the Sheehan Disability Scale (SDS).

Also, if you make them do a scale or two on the initial - what do you make them repeat on f/u?

i have a digital one. they step on it and my MAs will record their weight. We do this every few visits...

 

[Tenesma]

jcm800 - lol

seriously i think pain scales are useless, i think disability scales are useless (most of the patients who this would apply to are usually already on disability and have no intention of coming off disability), i think depression scales can be helpful but I am not interested in managing depression, and while Fear-Avoidance is an interesting one, I can usually just examine them and have the answer on that one right away...

 

[Jitter Bug]

We use Oswestry and Neck Pain, and we do before and after a course of physical therapy. These are helpful because people have an idea what kind of changes in ODI are clinically relevant. (By people I mean insurance companies and work comp carriers that we market to to send us work)

We also do the pain diagram which sometimes one glance at that thing and I know exactly what I'm walking in on! Not sure if it has any utility beyond that. ie research purposes.

The rest sound nice in abstract, but clinically a few minutes of conversation I can pick up what their life is like and if they are depressed. Plus questionnaires piss people off. Talking to their doctor makes them feel special and cared for. (Ha Ha)