OBJECTIVES: To develop patient estimates of meaningful change on a verbal descriptor scale in chronic pain.

METHODS: Participants with self-reported chronic pain were recruited using population sampling methods. Participants completed a survey assessing meaningfulness of changes on pain scales. Participants were asked to estimate what would be a meaningful improvement and a meaningful worsening to them on a six-point verbal descriptor scale (VDS) (no symptoms, very mild, mild, moderate, severe, very severe). Additionally, participants that had indicated improvement in symptoms over the past year on a five-point patient global impression of change (PGIC) scale (much better, a little better, no change, a little worse, much worse) were asked to explain whether that improvement was meaningful to them. Participants also assigned a number on a 10-point numeric response scale (0=healthiest to 10=sickest) to the six-point VDS and PGIC response options.

RESULTS: 171 participants completed the survey. The mean ratings for meaningful improvement and worsening on the six-point VDS were 1.43 points and 1.01 points, respectively. The mean values participants assigned to the PGIC categories using the NRS ordered as expected. Most respondents (79%) reported a change in their chronic pain over the past year on the PGIC. All respondents reporting improvement indicated that the change was meaningful to them regardless of how much the pain improved.

CONCLUSIONS: Chronic pain was chosen for this exercise assuming the population’s experience with pain over time would allow them to reflect on their experience and derive an estimate for meaningful change in their pain status. Respondents’ point estimates for meaningful improvement and worsening on a six-point VDS differed, indicating that worsening required less change to be considered meaningful. Although the exercise was based on historical experience in this cross-sectional evaluation, these estimates may represent a level expected by patients who experience chronic pain.