Moving beyond pain intensity as the primary outcome measure: the INTEGRATE pain framework and beyond

In clinical trials as well as routine clinical care, pain intensity is currently the primary research outcome that is used to identify the impact of pain management treatments. However, assessment of this domain alone hinders the understanding of the impact of pain and pain-related symptoms for patients. To advance the management of pain, we need to (1) measure bio-psycho-social outcomes that are important to all stakeholders, including to those with lived pain experience, (2) ensure harmonization of outcome assessment by implementing core outcome sets, (3) use assessment tools that have been validated and have content validity, (4) use the same questionnaires in both research and clinical practice so that research informs clinical practice and vice versa, and (5) consider tailoring questionnaires to the person with lived pain experience, eg, by moving toward an idiographic approach. The pain management field is moving toward a personalized approach to care and the use of harmonized/standardized patient-reported outcomes, and patient-reported outcome measures can help advance the pain management field and make care more patient-centered.