eMeasure Title

Oncology: Medical and Radiation - Pain Intensity Quantified

eMeasure Identifier (Measure Authoring Tool) 157 eMeasure Version number 6.0.000
NQF Number 0384 GUID 9a0330d0-3d9b-11e1-8634-00237d5bf174
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward PCPI(R) Foundation (PCPI[R])
Measure Developer American Medical Association (AMA)
Measure Developer PCPI(R) Foundation (PCPI[R])
Endorsed By National Quality Forum
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified
Copyright 2017 PCPI(R) Foundation and American Medical Association. All Rights Reserved.
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Measure Scoring Proportion
Measure Type Process
Measure Item Count
Encounter, Performed: Office Visit
Measure Item Count
Encounter, Performed: Face-to-Face Interaction
Measure Item Count
Procedure, Performed: Radiation Treatment Management
Risk Adjustment
Rate Aggregation
Initial and ongoing pain assessments are essential to ensure proper pain management among patients with cancer.  An inadequate assessment of pain is linked to poor pain control.  Unrelieved pain has a significant impact on patients' quality of life, denying them comfort and greatly affecting their activities, motivation, and interactions with family and friends. Additionally, there is growing evidence that cancer survival is associated with effective pain management.  (NCCN, 2016)
Clinical Recommendation Statement
-All patients must be screened for pain at each contact. 
-Pain intensity must be quantified and quality must be characterized by the patient (whenever possible based on patient communication capacity).
-Comprehensive pain assessment must be performed if new or worsening pain is present and regularly performed for persisting pain.
-Pain assessment is essential with a rating scale but also includes patient reporting of qualities of the pain, breakthrough pain, treatments used and their impact on pain, patient reporting of adequate comfort, satisfaction with pain relief, provider assessment of adequacy of function, and any special issues for the patient relevant to pain treatment. If necessary, get additional information for family/ caregiver regarding pain and impact of function. 
-Evaluate the patient for risk factors of opioid misuse. 
(Category 2A) (NCCN, 2016)

Various methods and tools exist to assess pain severity. Intensity of pain should be quantified using a numerical rating scale (ie, 0-10), visual analog scale, categorical scale, or pictorial scale (eg, The Faces Pain Rating Scale). (Category 2A) (NCCN, 2016)
Improvement Notation
Higher score indicates better quality
National Comprehensive Cancer Network (NCCN). Clinical Practice Guidelines in Oncology: Adult Cancer Pain. Version 2.2016. Available at: http://www.nccn.org.
This measure is an episode-of-care measure; the level of analysis for this measure is every visit for patients with a diagnosis of cancer who are also receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face encounter with the physician while the patient is receiving treatment. For purposes of calculating this measure, eligible encounters for patients receiving chemotherapy will include those encounters where the patient has been administered chemotherapy within 30 days prior to the encounter and also been administered chemotherapy within 30 days after the date of the encounter. For example, at every visit for patients with a diagnosis of cancer who are also receiving chemotherapy or radiation therapy, the patient should have pain intensity quantified.

Pain intensity should be quantified using a standard instrument, such as a 0-10 numeric rating scale, visual analog scale, a categorical scale, or the pictorial scale. Examples include the Faces Pain Rating Scale and the Brief Pain Inventory (BPI).
Transmission Format
Initial Population
All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy
Equals Initial Population
Denominator Exclusions
Patient visits in which pain intensity is quantified
Numerator Exclusions
Not Applicable
Denominator Exceptions
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Table of Contents

Population Criteria

Data Criteria (QDM Variables)

Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables

Measure Set