Amanda L Stone1, Zaria Williams2, Melissa McNaull3, Anna C Wilson4, Cynthia W Karlson3. 1. Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA. 2. Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA. 3. Division of Hematology-Oncology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA. 4. Department of Pediatrics, Institute on Development and Disability, Oregon Health and Science University, Portland, OR, USA.
Abstract
BACKGROUND: Opioid analgesics are frequently used in the home setting to manage episodic pain in youth with sickle cell disease (SCD). Given the risk of adverse side effects, including constipation and sedation, understanding factors associated with at-home opioid use is important for maximizing pain relief while minimizing negative side effects. PURPOSE: The present study aimed to evaluate the relationship between individual psychological factors (pain catastrophizing and negative affect), caregiver psychological factors (catastrophizing about child's pain and caregiver negative affect), and home opioid use in youth with SCD. METHODS: Youth with SCD (n = 32) and a caregiver (n = 28) recruited during a routine outpatient hematology visit completed electronic 14 day diaries assessing pain, opioid use, and psychological factors. RESULTS: Approximately 28% of youth (n = 9) reported pain ≥50% of diary days and a third of youth (n = 11, 34%) used opioid analgesics at least one of the diary days. The number of days opioid analgesics were used ranged from 0 to 7 (50% of diary days). Results from generalized linear mixed models indicated greater child negative affect accounted for increased odds of opioid use on a given day when accounting for pain intensity. Greater caregiver catastrophizing about children's pain was also associated with increased odds of children's opioid use. CONCLUSIONS: Child and parent psychological factors relate to child opioid use at home for SCD-related pain. Future research is warranted in larger samples to identify targets for interventions to enhance pain management while reducing opioid-related risk and side effects.
BACKGROUND: Opioid analgesics are frequently used in the home setting to manage episodic pain in youth with sickle cell disease (SCD). Given the risk of adverse side effects, including constipation and sedation, understanding factors associated with at-home opioid use is important for maximizing pain relief while minimizing negative side effects. PURPOSE: The present study aimed to evaluate the relationship between individual psychological factors (pain catastrophizing and negative affect), caregiver psychological factors (catastrophizing about child's pain and caregiver negative affect), and home opioid use in youth with SCD. METHODS: Youth with SCD (n = 32) and a caregiver (n = 28) recruited during a routine outpatient hematology visit completed electronic 14 day diaries assessing pain, opioid use, and psychological factors. RESULTS: Approximately 28% of youth (n = 9) reported pain ≥50% of diary days and a third of youth (n = 11, 34%) used opioid analgesics at least one of the diary days. The number of days opioid analgesics were used ranged from 0 to 7 (50% of diary days). Results from generalized linear mixed models indicated greater child negative affect accounted for increased odds of opioid use on a given day when accounting for pain intensity. Greater caregiver catastrophizing about children's pain was also associated with increased odds of children's opioid use. CONCLUSIONS:Child and parent psychological factors relate to child opioid use at home for SCD-related pain. Future research is warranted in larger samples to identify targets for interventions to enhance pain management while reducing opioid-related risk and side effects.
Authors: Jeffrey Schatz; Alyssa M Schlenz; Catherine B McClellan; Eve S Puffer; Steven Hardy; Matthew Pfeiffer; Carla W Roberts Journal: Clin J Pain Date: 2015-06 Impact factor: 3.442
Authors: Barbara P Yawn; George R Buchanan; Araba N Afenyi-Annan; Samir K Ballas; Kathryn L Hassell; Andra H James; Lanetta Jordan; Sophie M Lanzkron; Richard Lottenberg; William J Savage; Paula J Tanabe; Russell E Ware; M Hassan Murad; Jonathan C Goldsmith; Eduardo Ortiz; Robinson Fulwood; Ann Horton; Joylene John-Sowah Journal: JAMA Date: 2014-09-10 Impact factor: 56.272