An algorithm that assembles items from interRAI assessment instruments (including the US Nursing Home Minimum Data Set) to represent severity of pain.

Fries BE, Simon SE, Morris JN, Flodstrom C, Bookstein F

Can be used with all interRAI instruments (nursing home, home care, palliative care, assisted living, etc.)

Currently used in home care, nursing homes, palliative care, assisted living and other community settings.

Originally derived on a sample of 95 nursing home residents in 25 Medicare-certified facilities in Massachusetts. Prevalence reported on the full population of 34,675 residents in all Michigan nursing facilities from October 1998 – October 1999. In the prevalence sample of post-acute nursing home patients, 47% evidenced pain, while 4% experienced excruciating pain.

Patients or residents in multiple settings.

Nursing home, home care, assisted living, community settings.

4-category pain scale

Validated against the Visual Analog Scale. The MDS pain frequency and MDS pain intensity items – used to form the MDS Pain Scale - each had measured inter-rater reliability of 0.73 (weighted kappa – Fleiss-Cohen weights).

Only pain.

Based on measures of the Visual Analog Scale, which is determined by direct questioning of the individual.

An algorithm may calculate one or more scores based on elements of the assessment.

Can stand alone for more frequent monitoring of pain than mandated for full MDS or interRAI instruments.

Version 1.

Algorithm is in the public domain. interRAI instruments are copyrighted but license for governments and caregivers to use them is provided via contracts without royalty.

Fries BE, Simon SE, Morris JN, Flodstrom C, Bookstein FL. “Pain in US Nursing Homes: Validating a Pain Scale for the Minimum Data Set” Gerontologist 41(2):173-179, 2001

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