Enhancing pain care with the American Pain Society Patient Outcome Questionnaire for use in the Emergency Department (APS-POQ-RED): validating a patient-reported outcome measure

Pain is the most common symptom experienced when presenting to the emergency department (ED). Estimates indicate over half of all patients will present in pain. EDs typically focus on care process measures, such as time to first analgesic medication. Process-based metrics remove the patient from their own experience. Unfortunately, when patient-reported measures of pain care are used in the ED for quality improvement or research, they vary widely and often lack validation. Previous work has demonstrated that a modified version of the American Pain Society – Patient Outcome Questionnaire – Revised Edition (APS-POQ-R) may provide an ideal patient-reported outcome measure for the adult ED population. However, previous work has left validation incomplete. In this multi-site, multistage research, we demonstrate the construct, convergent and divergent validity and the internal consistency of a modified version of the APS-POQ-R in adult patients presenting to two large, inner-city EDs with moderate to severe acute pain. After three stages of psychometric testing in 646 patients, we present a nine-question, three construct patient-reported outcome measure for moderate to severe pain in the adult emergency department, now known as the American Pain Society – Patient Outcome Questionnaire – Revised for the ED (APS-POQ-RED). Perspective This article presents the psychometric properties of a revised version of the APS-POQ-R for use in the adult ED. This shortened, ED-specific patient-reported outcome measure (APS-POQ-RED) seeks to provide a standardised, validated measure of patient-reported outcomes of acute pain care in the ED for quality and research purposes.