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Quality indicators to assess quality of pain clinic care from the perspective of patients with chronic pain

development, usability, comprehensibility, and psychometric quality of the QiPPP questionnaire

de Meij, Nellekea,*; Köke, Albèreb,c,d; Thomassen, Ilonae; Kallewaard, Jan-Willemf; van Kleef, Maartena; van der Weijden, Trudyg

doi: 10.1097/j.pain.0000000000001371
Research Paper
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To address the lack of appropriate patient-defined quality indicators (QIs) for assessment of pain clinic care in the Netherlands, we developed the “Quality Indicators Pain Patients' Perspective” (QiPPP) questionnaire. Quality indicators are widely used to measure the quality of the structure, process, and outcome of health care. The Pain Patient United Consortium, together with the University Pain Centre of Maastricht, developed QIs for assessment of care. The aim of this study was to develop QIs from the perspective of patients with chronic pain for assessment of the care provided by a pain clinic, and to validate them on usability, comprehensibility, and psychometric quality in daily pain practice. Quality as defined by patients with chronic pain (in survey and focus groups) was prioritized by consensus and transformed into QI. A first set was tested and fine-tuned, resulting in the QiPPP questionnaire. Five participating pain clinics distributed 200 questionnaires among consecutive patients with chronic pain under treatment. To examine the dimensionality of the QIs, patient responses were analyzed on the basis of reporting frequencies and findings of principal component analysis. For construct validation, the influence of patient characteristics was observed in 3 components. A total of 547 (54.7%) populated QiPPP questionnaires (response rate, 58.9%) were analyzed. The mean score for patient comprehensibility was 8.6 ± 1.4. The final QiPPP questionnaire included 21 QIs (18 process; 3 outcome) distributed over 7 domains. The QiPPP questionnaire was of sufficient psychometric quality and found to be useful and understandable by patients with chronic pain.

Quality indicators (18 process; 3 outcome) were developed from the perspective of patients suffering from chronic pain for the assessment of care provided by a pain clinic.

aUniversity Pain Centre Maastricht (UPCM), Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, the Netherlands

bDepartment of Rehabilitation Medicine, CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands

cAdelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands

dFaculty of Health and Technology, Zuyd University for Applied Sciences, Heerlen, the Netherlands

ePain Patients United Consortium, Leiden, the Netherlands

fDutch Society of Anesthesiologists, Utrecht, the Netherlands

gDepartment of Family Medicine, CAPHRI, School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands

Corresponding author. Address: University Pain Center Maastricht (UPCM), Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre (MUMC+), Post Box 5800, Maastricht 6202 AZ, the Netherlands. Tel.: +31 43 3872335; fax: +31 43 3875457. E-mail address: p.de.meij@mumc.nl (N. de Meij).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).

Received October 16, 2017

Accepted August 06, 2018

© 2018 International Association for the Study of Pain
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