Untangling the Determinants of Pain in Sickle Cell Disease

Results in Context

According to Dr Harris, these findings suggest that, in regard to the frequency or severity of SCD-related pain, it does not make a difference how educated an individual is. Furthermore, the results indicate that neither income nor level of educational attainment were associated with pain episode frequency or severity.

In contrast, both age and sex were associated with pain episode frequency and severity, with female patients experiencing more regular and severe pain episodes compared to their male counterparts.

Notably, depression was significantly associated with pain episode frequency, which is critical considering the disproportionate impact SCD has on people of African descent, coupled with the stigma that Black patients often encounter when they seek care for vaso-occlusive crises.

“Unfortunately, many patients with sickle cell disease encounter negative bias and stereotypes when they seek treatment for pain in the emergency department,” commented Dr Harris in an interview with Hematology Advisor. “The Sickle Cell Disease Implementation Consortium (SCDIC) has developed a training video to dispel negative myths about individuals with SCD who present in pain.”

Future Directions

Now that we know of these associations, Dr Harris noted that further investigation is needed to build upon the findings of this study. Future work should include continued data collection with a focus on depression symptoms, diagnosis, and treatment, as well as additional analyses evaluating causation.

She also stressed the importance of developing better screening tools for depression, as well as effective treatment interventions. Lastly, Dr Harris recommended that clinicians should also consider and incorporate holistic or comprehensive approaches to pain management.

Reference

Harris KM, Preiss L, Varughese T, et al. Examining Mental Health, Education, Employment, and Pain in Sickle Cell Disease. JAMA Netw Open. 2023;6(5):e2314070. doi:10.1001/jamanetworkopen.2023.14070

This article originally appeared on Hematology Advisor