Management of Sickle Cell Disease Pain among Adolescent and Pediatric Patients

Abstract

Management of sickle cell pain in adolescent and pediatric patients is inadequate, and the employment of proper management guidelines and practices are highly variable among different regions and populations. APPT, the multidimensional adolescent pediatric pain tool, promotes optimal pain management and introduces best practical guidelines for pain management. The goal of this study is to assess pain and pain management among young patients diagnosed with sickle cell disease (SCD) by introducing the APPT as a tool for pain management, and analyze factors contributing to pain management. Information relevant to demographic data, SCD characteristics, APPT assessment, and satisfaction of patients regarding pain management were collected using a structured questionnaire. Results showed that SCD is highly associated with gender (p = 0.022), consanguinity (p = 0.012), and number of surgeries (p = 0.013). Most patients (58.9%) indicated the involvement of more than six body areas affected during pain crisis. Severe pain was described by more than half the patients (55.6%), while moderate pain was reported by 31.1%. Most patients described their pain by sensory, affective, and temporal words. The number of painful areas, pain intensity, and use of descriptive pain words was correlated and interpreted by age, BMI, school absence, and number of surgeries. Results of this study could provide guidance to healthcare providers to improve current practices for SCD pain management in order to improve health outcomes and patients’ satisfaction.

Clients’ satisfaction with pain management by healthcare providers during sickle cell crisis in selected health facilities in Ogun State Nigeria – a cross sectional study

“…Evaluation of the level of pain experienced by the participants showed that the majority experienced mild pain, while a few participants had severe pain. This result was not in agreement with the report of Abdo et al, in which most participants experienced severe to moderate pain, which could be attributed to the lack of self-care knowledge that could have helped in alleviating pain [38]. The reason for the low proportion of participants in this study with moderate/sever pain compared to the study by Abdo et al study might be that while their study was conducted among SCD patients in a secondary/tertiary level hospital, ours was conducted among patients attending a primary level of health care [38].…”

“…This result was not in agreement with the report of Abdo et al, in which most participants experienced severe to moderate pain, which could be attributed to the lack of self-care knowledge that could have helped in alleviating pain [38]. The reason for the low proportion of participants in this study with moderate/sever pain compared to the study by Abdo et al study might be that while their study was conducted among SCD patients in a secondary/tertiary level hospital, ours was conducted among patients attending a primary level of health care [38]. Usually, primary level health care involves uncomplicated simple cases, while complicated ones are referred to secondary/tertiary level health care facilities.…”

“…The clinical characteristic results showed that a larger proportion of the participants had an HbSS blood group while a few had SC. This result agrees with the previous findings that there are more people with HbSS genotype compared to HbSC [3,38,40]. This gender distribution revealed that an equal proportion of participants by gender had HbSS; however, more females than males had HbSC.…”

“…dIscussIon There were more female participants than males. This is similar to a recent study conducted by Abdo et al [38] among adolescent and paediatric patients, which recorded more female participants, and likewise the findings of Elander et al [39]. The modal age range was 18-20 years.…”

Comment on: Intraindividual pain variability metrics for youth with sickle cell disease: Relations to health outcomes

“…This research divides patients into subgroups to look at pain variability differently. 5 The authors might have examined intraindividual pain variability and subgroup membership by including these subgroup classifications. In 2019, the Pediatric Pain Screening Tool was used to assess chronic pain risk factors in sickle cell patients.…”