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Joan Stephenson, PhD

JAMA. 1999;281:978.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The US Department of Veterans Affairs (VA) is instructing physicians and nurses who treat veterans to regard pain as a "fifth vital sign" to be routinely assessed along with blood pressure, pulse, temperature, and respiration.

Numerous studies indicate that pain is often unrecognized or inadequately treated. The agency found that recent VA initiatives to improve end-of-life care for veterans revealed that pain management was not well addressed in dying patients.

The new directive, aimed at addressing pain in a more systematic and thorough manner, is part of an effort to reduce pain and suffering experienced by many of the 3.4 million veterans cared for by the VA. Physicians and nurses will ask patients to rate their pain on a scale of 1 to 10 and discuss ways to manage it.

The VA plans to have the program in place at the 1100 sites where it delivers health . . . [Full Text of this Article]