A Qualitative Study of Chronic Pain and Self-Management in Adults with Sickle Cell Disease

Matthie, Nadine; Ross, Diana; Sinha, Cynthia; Khemani, Kirshma; Bakshi, Nitya; Krishnamurti, Lakshmanan

doi:10.1016/j.jnma.2018.08.001

Cited by 21 publications

(23 citation statements)

References 39 publications

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“…We found worse chronic pain and chronic pain disability in older participants, and females had greater pain catastrophizing. These findings are consistent with previous reports of a high incidence of chronic pain in individuals with SCD and the association with various patient-reported outcomes (Badawy et al, 2018;Karafin et al, 2019;Matthie et al, 2018;Smith et al, 2008;Taylor et al, 2010;Thompson and Eriator, 2014). Our findings also support the pain prone phenotype for developing chronic pain that has been described in non-SCD conditions (Phillips and Clauw, 2013).…”

Section: Discussionsupporting

confidence: 93%

“…Adults with SCD use self-management strategies to cope with pain (Jenerette et al, 2011a; Matthie et al, 2015, 2018; Matthie and Jenerette, 2015, 2017; Tanabe et al, 2010). Among these individuals, those who demonstrate higher self-efficacy have greater social support, a higher educational level, and tend to employ more self-management strategies to cope with acute pain (Matthie et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and predictors of chronic pain intensity and disability among adults with sickle cell disease

Matthie

Jenerette

Gibson

et al. 2020

Health Psychology Open

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Among 170 adults with sickle cell disease, we evaluated chronic pain impact and disability prevalence, assessed age and gender differences, and identified psychosocial predictors of chronic pain intensity and disability. Most participants had a high level of disability. Chronic pain intensity and disability were significantly associated with pain catastrophizing and chronic pain self-efficacy, and worsened with age. Further research is needed to confirm study findings and develop interventions, including palliative care approaches that address catastrophizing and disability, particularly for young women and middle-aged adults with sickle cell disease. Moreover, consistent clinical assessment of chronic pain and psychosocial health should be implemented.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of chronic pain intensity and disability among adults with sickle cell disease

Matthie

Jenerette

Gibson

et al. 2020

Health Psychology Open

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“…Acute pain and chronic pain are often interlinked, with most cases of chronic pain beginning as acute pain. 57 Acute pain flares may recur periodically in chronic medical problems, including arthritis, 58 neuropathies, 59 spinal conditions, low-back pain, 60 sickle cell disease (SCD), 61 migraine, 62 multiple sclerosis (MS), 63 trigeminal pain or neuralgia, 64 and complex regional pain syndrome (CRPS). 65 As with acute pain flares in these and other conditions, it is important to perform a thorough evaluation that leads to a presumed diagnosis or differential diagnosis.…”

Section: Acute and Chronic Painmentioning

confidence: 99%

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Darnall¹,

Krishnamurthy²,

Tsuei³

et al. 2020

JMIR Form Res

104

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Background Patients with chronic pain often have limited access to comprehensive care that includes behavioral pain management strategies. Virtual reality (VR) is an immersive technology and emerging digital behavioral pain therapy with analgesic efficacy for acute pain. We found no scientific literature on skills-based VR behavioral programs for chronic pain populations. Objective The primary aim of this study is to evaluate the feasibility of a self-administered VR program that included content and skills informed by evidence-based behavioral treatment for chronic pain. The secondary aim is to determine the preliminary efficacy of the VR program in terms of average pain intensity and pain-related interference with activity, stress, mood, and sleep, and its impact on pain-related cognition and self-efficacy. The tertiary aim was to conduct a randomized controlled trial (RCT) and compare the VR treatment with an audio-only treatment. This comparison isolated the immersive effects of the VR program, thereby informing potential mechanisms of effect. Methods We conducted an RCT involving a web-based convenience sample of adults (N=97) aged 18-75 years with self-reported chronic nonmalignant low back pain or fibromyalgia, with an average pain intensity >4 over the past month and chronic pain duration >6 months. Enrolled participants were randomly assigned to 1 of 2 unblinded treatments: (1) VR: a 21-day, skills-based VR program for chronic pain; and (2) audio: an audio-only version of the 21-day VR program. The analytic data set included participants who completed at least 1 of 8 surveys administered during the intervention period: VR (n=39) and audio (n=35). Results The VR and audio groups launched a total of 1067 and 1048 sessions, respectively. The majority of VR participants (n=19/25, 76%) reported no nausea or motion sickness. High satisfaction ratings were reported for VR (n=24/29, 83%) and audio (n=26/33, 72%). For VR efficacy, symptom improvement over time was found for each pain variable (all P<.001), with results strengthening after 2 weeks. Importantly, significant time×group effects were found in favor of the VR group for average pain intensity (P=.04), pain-related inference with activity (P=.005), sleep (P<.001), mood (P<.001), and stress (P=.003). For pain catastrophizing and pain self-efficacy, we found a significant declining trend for both treatment groups. Conclusions High engagement and satisfaction combined with low levels of adverse effects support the feasibility and acceptability of at-home skills-based VR for chronic pain. A significant reduction in pain outcomes over the course of the 21-day treatment both within the VR group and compared with an audio-only version suggests that VR has the potential to provide enhanced treatment and greater improvement across a range of pain outcomes. These findings provide a foundation for future research on VR behavioral interventions for chronic pain.

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“…Such painful events may be acute or chronic, treated on an inpatient or outpatient basis, or managed with opioid or nonopioid medications [6]. However, poorly treated acute pain may evolve into psychological problems, reduced quality of life, chronic opioid use, frequent health care usage, and chronic pain syndromes [7,8]. Studies have shown that up to 30% of adolescents with SCD will ultimately develop chronic pain [9].…”

Section: Introductionmentioning

confidence: 99%

The Role of Cognitive Behavioral Therapy in Opioid Use Reduction in Pediatric Sickle Cell Disease: Protocol for a Systematic Review

2019

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Background Sickle cell disease (SCD) is a genetic disorder of red blood cells that results in acute and chronic health problems, including painful syndromes. Opioid analgesia is the mainstay of moderate to severe pain management in SCD, although adjunctive psychosocial approaches such as cognitive behavioral therapy (CBT) are increasingly incorporated. CBT has been used in populations of various ages to address a wide range of issues, such as mood disorders and chronic pain. It is unclear if effective CBT reduces the use of opioids to manage pain in pediatric SCD. Objective The aim of this study is to evaluate the association between CBT and decreased opioid use in children with SCD. Methods In this systematic review protocol, we describe our approach to applying predetermined eligibility criteria to searches of PubMed (including Medline), Embase, Cochrane, Web of Science, and PsycINFO databases, as well as Google Scholar and grey literature. In particular, we will use keywords to search for English-language studies of individuals with SCD aged 21 years old and younger published before November 2018. Keywords will allow us to assess for the primary outcome—total use of opioid medications—and the secondary outcomes—pain intensity and emotional functioning—during pain management using a combined opioid and CBT approach, opioids alone, or CBT alone. The review team will use standardized abstraction forms to review articles at the title, abstract, and full-text levels. Finally, reviewers will assess the risk for bias, quality of evidence, and adequacy of data for quantitative versus qualitative synthesis. If meta-analysis is deemed inappropriate, a narrative review will be conducted. Results We will report a summary of findings across studies that meet eligibility criteria to compare the extent to which adjunctive CBT is associated with decreased opioid use among children with SCD. Conclusions This systematic review will present the current state of the evidence on CBT and opioid use in pediatric SCD, which may inform clinical practice and health policy to support optimized pain management. International Registered Report Identifier (IRRID) PRR1-10.2196/13211

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A Qualitative Study of Chronic Pain and Self-Management in Adults with Sickle Cell Disease

Cited by 21 publications

References 39 publications

Prevalence and predictors of chronic pain intensity and disability among adults with sickle cell disease

Prevalence and predictors of chronic pain intensity and disability among adults with sickle cell disease

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

The Role of Cognitive Behavioral Therapy in Opioid Use Reduction in Pediatric Sickle Cell Disease: Protocol for a Systematic Review

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