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Definition and assessment of chronic pain in advanced disease 

Definition and assessment of chronic pain in advanced disease
Chapter:
Definition and assessment of chronic pain in advanced disease
Author(s):

Clare Rayment

and Michael I. Bennett

DOI:
10.1093/med/9780199656097.003.0093
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date: 07 May 2021

This chapter discusses the various definitions applied to pain including chronic, nociceptive, neuropathic, and breakthrough. It gives a broad overview of the epidemiology of pain including its prevalence of greater than 50% in those patients with advanced disease and its under-treatment. The second part of the chapter explains how best to characterize the pain complaint. It acknowledges the importance of a thorough history, including pain characteristics such as severity and associated features. Several pain measurement scales, which can be used both in clinical practice and research, are presented. Clinical examination and imaging are also discussed as aids to diagnosis and management of pain. It concludes with how to assess pain in the context of a palliative plan of care, stressing the need to consider the many challenges that patients face with advancing disease and how the management of pain is affected by other symptoms patients may have.

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