Concordance of Pain Detection Using the Doloplus and Algoplus Behavioral Scales

To the Editor: Pain is highly prevalent with aging and affects 50% to 90% of older adults.1, 2 Communication disorders and cognitive impairment in elderly adults are an obstacle to adequate diagnosis and treatment of pain. Behavioral scales such as the Algoplus and Doloplus have therefore been developed to assess acute and chronic pain in older adults with communication disorders. Doloplus, a 30-item scale, was one of the first scales to be developed for chronic pain and has been validated in several languages.3, 4 Likewise, Algoplus, a five-item scale for acute pain evaluation, has been validated in several languages.5, 6 In clinical practice, Algoplus has become popular because of its rapidity of administration and is today more often used than Doloplus even in nonacute pain situations. Clinicians are concerned that this trend might lead to underestimation and nontreatment of chronic pain. The Doloplus Collective team performed the present study to assess the concordance of pain detection between Algoplus and Doloplus, with the aim of reinforcing efficient pain assessment in vulnerable elderly adults with communication disorders. A prospective, multicenter, observational study was conducted in 12 French geriatric and palliative care wards in 228 individuals with communication disorders (n = 139 women aged 85.6 ± 6.5; n = 89 men aged 82.3 ± 7.6). Two persons assessed pain: first, a doctor or nurse using a numerical rating scale and then using the Algoplus and second, a doctor or nurse using the Doloplus within 10 minutes after the first assessment to ensure that the individual's pain situation was unchanged and to avoid interference between the pain assessments. Scores were compared using Spearman correlation coefficients (r) and kappa coefficients (significance