Neuropathic pain is associated with poor health‐related quality of life in adolescents with sickle cell disease: A preliminary report

Abstract

Background: Neuropathic pain is associated with poor health-related quality of life (HRQL) in pain conditions other than sickle cell disease (SCD); this relationship in SCD is unknown. We investigated this relationship and hypothesized neuropathic pain is associated with poor HRQL in adolescents with SCD. Methods: We conducted a cross-sectional study of patients with SCD ages 13-18 years during baseline health. Primary outcome was HRQL, assessed by the PedsQL SCD Module (child self-report, parent proxy report). PedsQL is scored from 0 to 100, with higher scores indicating better HRQL. Neuropathic pain was assessed using the painDETECT questionnaire (scored 0-38); higher scores indicated greater likelihood of neuropathic pain. All completed both PedsQL SCD Module and painDETECT questionnaire. Descriptive statistics were used and associations between painDETECT and PedsQL Total Score, Pain Impact, Pain and Hurt, and Pain Management and Control Scores were determined via Pearson correlation. Significance was P < .05. Results: Twelve patients were enrolled. Median (interquartile range [IQR]) age was 15 (14-16.5) years, 75% were female, and 83% were on hydroxyurea. Higher painDETECT scores were significantly associated with lower PedsQL SCD Module child self-report Pain and Hurt Scores (r = −0.68, P = .01). Higher painDETECT scores were also significantly associated with lower PedsQL parent proxy-report Total Scores (r = −0.64, P = .03) and Pain and Hurt Scores (r = −0.67, P = .02). Conclusions: These data suggest that adolescents with SCD and neuropathic pain have poor HRQL even in their baseline state of health. Prospective, larger studies are needed to confirm this preliminary finding and explore a multimodal approach for pain assessment in SCD. K E Y W O R D S health-related quality of life, neuropathic pain, sickle cell disease Abbreviations: HRQL, health-related quality of life; IQR, interquartile range; PedsQL, pediatric quality-of-life inventory; PRO, patient-reported outcome; SCD, sickle cell disease 1 INTRODUCTION Sickle cell disease (SCD) is an inherited hemoglobinopathy affecting ∼100 000 people in the United States. 1,2 The hallmark complication of

Prevalence of neuropathic pain in adolescents with sickle cell disease: A single‐center experience

“…5,10,12 This is likely due to the lack of a standard approach to identify NP in this population. Because NP has been shown to significantly decrease the QoL in patients with SCD, 3,4 it is essential that we are diligent in assessing for and identifying those who may benefit from targeted therapy.…”

“…Acute and chronic pains are hallmarks of sickle cell disease (SCD). Acute pain is a leading cause of hospitalization for patients with SCD, 1,2 and chronic pain can significantly contribute to decreased quality of life (QoL) in SCD 3,4 . The pathophysiology of sickle cell pain is complex and can be attributed to both nociceptive and neuropathic mechanisms 1 .…”

“…Age and female gender are also risk factors for NP in the general population. Despite recent evidence showing that NP is a substantial component of sickle cell pain, its pathophysiology in SCD and its targeted treatment are not completely understood 3,4,10,11,13–15 …”

“…Despite recent evidence showing that NP is a substantial component of sickle cell pain, its pathophysiology in SCD and its targeted treatment are not completely understood. 3,4,10,11,[13][14][15] The current practice of evaluating pain in SCD uses pain intensity scales such as the FACES and numeric rating scale (NRS). 16 These scales are unidimensional and only assess pain severity; they do not help in phenotypic characterization of pain.…”

Dor em crianças e adolescentes com doença falciforme: estudo observacional

“…Este achado confirma a hipótese de que esse tipo de dor traz mais prejuízos cognitivos, psicológicos e sociais para a qualidade de vida das crianças e adolescentes afetadas. [21][22][23][24] O tamanho reduzido da amostra e a aplicação em apenas um centro de referência impedem a generalização dos resultados. A baixa qualidade dos prontuários limitou a apresentação de outros dados clínicos relevantes.…”