Primary Submission Category: Interventions/Programs
Chronic Pain Treatment in Sickle Cell Disease: A Systematic Scoping Review of Controlled Trials
Authors: Rachel Bergmans David Sidhom Deena Aboul-Hassan Cherie Cofield Daniel Clauw
Presenting Author: Rachel Bergmans*
People with sickle cell disease are marginalized within healthcare systems; their experiences with race-based discrimination and fragmented care are well known. Among the patient community’s primary concerns is frequent and debilitating chronic pain. While sickle cell chronic pain is routinely treated with a strong opioid regimen, this approach carries a multitude of side effects and does not acknowledge the presence of mixed-pain states. We conducted a scoping review to appraise the quality of controlled trials that evaluate chronic pain treatments in sickle cell disease. We developed a search strategy for PubMed and EMBASE that included keywords for chronic pain and sickle cell. After screening 172 articles, we identified 7 original articles that met our inclusion criteria. Six studies recruited from clinics, and one recruited from the community. Pain was measured pre and post intervention to evaluate efficacy, and the pain analog scale was the most common measurement tool. Among these studies, a vaporized cannabis product reduced pain scores relative to a placebo, whereas a multimedia educational program was not associated with improved pain scores. Other studies that evaluated mindfulness-based interventions and hypnosis had promising findings but could not draw definitive conclusions due to small sample sizes. In conclusion, a variety of non-opioid treatments may be effective for treating sickle cell chronic pain, however, existing evidence is scarce. There is immense need for future research to develop and test chronic pain treatments for sickle cell disease.