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Daily assessment of pain in adults with sickle cell disease


, : Daily assessment of pain in adults with sickle cell disease. Annals of Internal Medicine 148(2): 94-101

Background: Researchers of sickle cell disease have traditionally used health care utilization as a proxy for pain and underlying vaso-occlusion. However, utilization may not completely reflect the amount of self-reported pain or acute, painful episodes (crises).Objective: To examine the prevalence of self-reported pain and the relationship among pain, crises, and utilization in adults with sickle cell disease.Design: Prospective cohort study.Setting: Academic and community practices in Virginia.Patients: 232 patients age 16 years or older with sickle cell disease.Measurements: Patients completed a daily diary for up to 6 months, recording their maximum pain (on a scale of 0 to 9); whether they were in a crisis (crisis day); and whether they used hospital, emergency, or unscheduled ambulatory care for pain on the, previous day (utilization day). Summary measures included both simple proportions and adjusted probabilities (for repeated measures within patients) of pain days, crisis days, and utilization days, as well as mean pain intensity.Results: Pain (with or without crisis or utilization of care) was reported on 54.5% of 31 017 analyzed patient-days (adjusted probability, 56%). Crises without utilization were reported on 12.7% of days and utilization on only 3.5% (unadjusted). In total, 29.3% of patients reported pain in greater than 95% of diary days, whereas only 14.2% reported pain in 5% or fewer diary days (adjusted). The frequency of home opiate use varied and independently predicted pain, crises, and utilization. Mean pain intensity on crisis days, noncrisis pain days, and total pain days increased as the percentage of pain days increased (P < 0.001). Intensity was significantly higher on utilization days (P < 0.001). However, utilization was not an independent predictor of crisis, after controlling for pain intensity.Limitations: The study was done in a single state. Patients did not always send in their diaries.Conclusion: Pain in adults with sickle cell disease is the rule rather than the exception and is far more prevalent and severe than previous large-scale studies have portrayed. It is mostly managed at home; therefore, its prevalence is probably underestimated by health care providers, resulting in misclassification, distorted communication, and undertreatment.

US$19.90

PMID: 18195334

DOI: 10.7326/0003-4819-148-2-200801150-00004


Other references

Casper, T.; Arbour, M.W., 2015: Identification of the pregnant woman who is using drugs: implications for perinatal and neonatal care. Neonatal abstinence syndrome (NAS) is a set of drug withdrawal symptoms that affect the central nervous, gastrointestinal, and respiratory systems in the newborn when separated from the placenta at birth. Maternal substance use of opioids, benzodi...

Salinas Casado, Jús.; Tellez, M.; Virseda, M.; Carlos Ramírez, J.; Silmi Moyano, A., 2008: Prevalence of urodynamic anomalies in women with recurrent urinary tract infection. To check the urodynamic data in patients with recurrent urinary tract infection in order to demonstrate a cause justifying them. We performed a transverse comparative study in a series of 114 women, with a mean age of 51.9 yr. (typical deviation:...

Xu, X.; Safran, S.A., 2017: Compressive elasticity of polydisperse biopolymer gels. We theoretically predict the nonlinear elastic responses of polydisperse biopolymer gels to uniaxial compression. We analyze the competition between compressive stiffening due to polymer densification by out-going solvent flow and compressive soft...

Silva, I.; Teixeira, A.; Oliveira, Jé.; Almeida, I.; Almeida, R.; Águas, A.; Vasconcelos, C., 2016: Endothelial Dysfunction and Nailfold Videocapillaroscopy Pattern as Predictors of Digital Ulcers in Systemic Sclerosis: a Cohort Study and Review of the Literature. Raynaud's phenomenon and digital ulcers (DUs) are frequent among systemic sclerosis (SSc) patients. Our aim was to investigate the diagnostic and predictive value for DU of endothelial dysfunction biomarkers (flow-mediated dilatation (FMD), s...

Shope T.C., 1975: Prevention of epstein barr virus induced infection in cotton topped marmosets by human serum containing epstein barr virus neutralizing activity. De-The, G , M A Epstein And H Zur Hausen (Ed ) Iarc (International Agency For Research on Cancer) Scientific Publications, No 11 Oncogenesis And Herpesviruses Ii, Part 2 Epidemiology, Host Response And Control Proceedings Of A Symposium Nuremberg, West Germany, Oct 14-16, 1974 Xiii+403p Illus International Agency For Research on Cancer: Lyon, France (Dist By Who, Geneva, Switzerland) 153-159

Haerich P.; Berg W.K., 1988: Modification of heart rate by selective attention in s1 s2 paradigm. Psychophysiology 25(4): 452

Vance, T., 1981: Geographic distribution. Serpentes, Coluber constrictor priapus. Herpetological Review 12.1: 13-14

Hoerauf, A.; Mand, S.; Fischer, K.; Kruppa, T.; Marfo-Debrekyei, Y.; Debrah, A.Yaw.; Pfarr, K.M.; Adjei, O.; Büttner, D.W., 2003: Doxycycline as a novel strategy against bancroftian filariasis-depletion of Wolbachia endosymbionts from Wuchereria bancrofti and stop of microfilaria production. Chemotherapy of onchocerciasis by doxycycline, which targets symbiotic Wolbachia endobacteria, has been shown to result in a long-term sterility of adult female worms and corresponding absence of microfilariae. It represents an additional chemothe...

Hamrah, P.; Pavan-Langston, D.; Dana, R., 2009: Herpes simplex keratitis and dendritic cells at the crossroads: lessons from the past and a view into the future. International Ophthalmology Clinics 49(1): 53-62

Garrido, A.C.; Chiappe, L.M.; Jackson, F.; Schmitt, J.; Dingus, L., 2001: First sauropod nest structures. Journal of Vertebrate Paleontology 21(3 Supplement): 52A-53A, 22 August