Background:
The Doloplus-2 is a pain assessment scale for assessing pain in older adults with cognitive impairment. It
is used in clinical practice and research. However, evidence for its measurement properties, feasibility and clinical utility
remain incomplete. This systematic review synthesizes previous research on the measurement properties, feasibility and
clinical utility of the scale.
Method:
We conducted a systematic search in three databases (CINAHL, Medline and PsycINFO) for studies published
in English, French, German, Dutch/Flemish or a Scandinavian language between 1990 and April 2017. We also
reviewed the Doloplus-2 homepage and reference lists of included studies to supplement our search. Two reviewers
independently reviewed titles and abstracts and performed the quality assessment and data abstraction.
Results:
A total of 24 studies were included in this systematic review. The quality of the studies varied, but many
lacked sufficient detail about the samples and response rates. The Doloplus-2 has been studied using diverse samples
in a variety of settings; most study participants were in long-term care and in people with dementia. Sixteen studies
addressed various aspects of the scale
’
s feasibility and clinical utility, but their results are limited and inconsistent across
settings and samples. Support for the scale
’
s reliability, validity and responsiveness varied widely across the studies.
Generally, the reliability coefficients reached acceptable benchmarks, but the evidence for different aspects of the
scale
’
s validity and responsiveness was incomplete.
Conclusion:
Additional high-quality studies are warranted to determine in which populations of older adults with
cognitive impairment the Doloplus-2 is reliable, valid and feasible. The ability of the Doloplus-2 to meaningfully
quantify pain, measure treatment response and improve patient outcomes also needs further investigation.