Do Numerical Rating Scales and the Roland-Morris Disability Questionnaire capture changes that are meaningful to patients with persistent back pain?

Abstract

Objectives: To investigate patients’ views about two common outcome measures used for back pain: Numerical Rating Scales for pain and the Roland-Morris Disability Questionnaire. Subjects: Thirty-six working adults who had previously sought primary care for back pain and who could speak and read English. Method: Eight focus groups were conducted to explore participants’ views about the 11-point Numerical Rating Scales and the 24-item Roland-Morris Disability Questionnaire. Each group was led by a facilitator and an interview topic guide was used. Audio recordings of focus groups were transcribed verbatim. Framework analysis was used to chart participants’ views and an interpretive analysis performed to explain the findings. Results: Participants reported that neither the Roland-Morris nor the Numerical Rating Scales captured the complex personal experience of pain or relevant changes in their condition. The time-frame of assessment was identified as particularly problematic and the Roland-Morris did not capture relevant functional domains. Conclusion: This study provides empirical data that working adults with persistent back pain consider these clinical outcome measures largely inadequate. These measures currently used for back pain may contribute to misleading conclusions about treatment efficacy and patient recovery.