Daily Assessment of Pain in Adults with Sickle Cell Disease

  title={Daily Assessment of Pain in Adults with Sickle Cell Disease},
  author={Wally R. Smith and Lynne T Penberthy and Viktor E. Bovbjerg and Donna K McClish and John D. Roberts and Bassam Dahman and Imoigele P Aisiku and James L Levenson and Susan D. Roseff},
  journal={Annals of Internal Medicine},
Context Although outpatient, emergency department, and hospital visits have been used as indicators of sickle cell disease severity, the relationship between health care use and pain episodes has not been well described. Contribution Two hundred thirty-two patients with sickle cell disease completed a daily diary for 6 months, providing 31017 patient-days for analysis. Patients reported pain on 56% of total patient-days, crises on 13%, and health care utilization on 4%. Implication Patients… 
Daily pain in adults with sickle cell disease—a different perspective
This first European study on pain in SCD indicates that pain appears to be significantly less frequent in the population as compared to previous study cohorts from the United States, and may be more representative for current SCD populations in other Western countries.
Sickle Cell Disease and Pain
Female sex, the presence of current leg ulcers, and the use of a strong opioid in the last 4 weeks produced higher odds of NP, whereas older age, milder genotypes, and daily analgesic use had the highest odds of CP.
The implementation of a web-based application to monitor daily pain levels is relevant to public health because it is likely to provide medical teams with the tools necessary to track patient pain levels more precisely and to enable healthcare providers to be more proactive with regard to pain management in patients with SCD.
Chronic pain persists in adults with sickle cell disease despite regular red cell transfusions.
  • M. Karafin, Danielle E Mullins, Joshua J Field
  • Medicine
    Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
  • 2019
Pain Management Issues as Part of the Comprehensive Care of Patients with Sickle Cell Disease
Acute pain in children and adults with sickle cell disease: management in the absence of evidence-based guidelines
The epidemiology and management strategies of acute pain events are examined, and limitations in the best available studies are identified.
Sickle cell disease: a natural model of acute and chronic pain.
A 19-year-old female patient with severe sickle cell disease (SCD) presented to her hematologist with severe pain, which significantly increased in frequency and severity between 16 and 19 years with 10 hospitalizations, and she reported almost daily pain.
Pain in sickle cell disease: the future of acute treatment
Advances in pain management for VOC must begin with an expanded definition of a VOC, and pre-emptive acute remittive drugs might be administered at home prior to hospitalization for V OC, saving money, pain and tissue damage.
Sickle-cell pain: advances in epidemiology and etiology.
New epidemiological findings recast pain in sickle-cell disease (SCD) as being more often a chronic manifestation than was previously thought, although acute pain is still the hallmark of the
Optimizing the management of chronic pain in sickle cell disease.
The complexity of managing chronic pain in SCD is discussed; pain that may be dependent or independent of the underlying SCD diagnosis, and emerging data suggests that chronic opioid therapy (COT) is a suboptimal treatment strategy for chronic pain.


Understanding pain and improving management of sickle cell disease: the PiSCES study.
The Pain in Sickle Cell Epidemiology Study (PiSCES) attempts to develop and validate a biopsychosocial model of SCD pain, pain response and healthcare utilization in a large, multisite adult cohort, suggesting targets for biobehavioral interventions over time.
Gender differences in pain and healthcare utilization for adult sickle cell patients: The PiSCES Project.
Contrary to many studies of pain, particularly chronic pain, men and women with SCD reported generally similar pain experiences.
Pain and stress in sickle cell disease: An analysis of daily pain records
Stress had significant positive associations with average pain intensity as well as reductions in household and social activities in adults with sickle cell disease, and stress predicted activity reductions even after controlling for pain intensity.
Pain in sickle cell disease. Rates and risk factors.
The "pain rate" is a measure of clinical severity and correlates with early death in patients with sickle cell anemia over the age of 20, and even when the fetal hemoglobin level is low, one can predict that small increments in the level may have an ameliorating effect on the pain rate and may ultimately improve survival.
Pain in Children and Adolescents With Sickle Cell Disease: An Analysis of Daily Pain Diaries
The results indicate that children with SCD usually experienced low levels of pain that was managed at home, sometimes without any medications, and as pain levels increased, children were more likely to use narcotic medications and health care services, although overall health care utilization during the 2-week period tended to be relatively infrequent.
Pain, quality of life, and coping in sickle cell disease.
This study examined the frequency and severity of sickle related pain, its impact on quality of life, and methods of coping for 25 children with sickle cell disease, aged 6-16 years. Subjects were
Assessment of painful episode frequency in sickle‐cell disease
It is suggested that nonhospital‐related painful episodes and shorter‐lasting episodes may contribute significantly to episode frequency, and measurement of frequency of all painful episodes would require consideration when evaluating episode frequency.
Pain, mood and opioid medication use in sickle cell disease.
  • K. Anie, A. Steptoe
  • Medicine, Psychology
    The hematology journal : the official journal of the European Haematology Association
  • 2003
Results suggest that opioid medication use is related to the impact of pain on daily life, and patients who use opioids more frequently for sickle cell pain show more disruption of their lives, with reduced activity levels and more pessimistic mood.