scholarly journals Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial

2018 ◽  
Vol 7 ◽  
pp. 216495611876955 ◽  
Author(s):  
Robert T Davis ◽  
Gary Badger ◽  
Kristina Valentine ◽  
Alexander Cavert ◽  
Remy R Coeytaux
Keyword(s):  
Chronic Pain ◽  
Sleep Disturbance ◽  
Pain Intensity ◽  
Physical Function ◽  
Treatment Period ◽  
Social Isolation ◽  
Pain Interference ◽  
Opioid Medication ◽  
Medicaid Population ◽  
Anxiety Depression

Introduction In response to the opioid crisis, the 2016 Vermont legislature commissioned a study to assess acupuncture for patients with chronic pain in the Vermont Medicaid population. Objective To assess the feasibility, acceptability, and effectiveness of acupuncture provided by licensed acupuncturists for Vermont Medicaid patients with chronic pain. Methods A total of 156 Medicaid patients with chronic pain were offered up to 12 acupuncture treatments within a 60-day period at the offices of 28 Vermont licensed acupuncturists. PROMIS® questionnaires were administered prior to and at the end of the treatment period to assess changes in pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance, and social isolation. Questionnaires also captured patients’ overall impressions of treatments as well as self-reported changes in medication use and work function. Results One hundred eleven women (71%) and 45 men (29%) with a wide range of pain complaints received a mean of 8.2 treatments during the intervention period. Measurements captured prior to and at the end of the treatment period showed significant improvements in group mean pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance, and social isolation as assessed by Patient-Reported Outcomes Measurement Information System (PROMIS) measures (paired t tests, P < .01). Fifty-seven percent of patients using analgesic (nonopioid) medication reported reductions in use. Thirty-two percent of patients using opioid medication reported reductions in use of opioid medication following the intervention. Seventy-four percent of employed patients reported improved capacity to work. Ninety-six percent of patients said that they would recommend acupuncture to others with chronic pain, and 91% reported qualitative improvements, including physical (31%), functional/behavioral (29%), and psycho-emotional (24%) improvements. Conclusions Our findings demonstrate that acupuncture treatment for chronic pain is feasible and well received by patients in the Vermont Medicaid population. Receiving care from Licensed Acupuncturists was associated with significant improvements in physical, functional, psycho-emotional, and occupational outcomes compared with before receiving acupuncture treatments.

scholarly journals Phase II double-blind randomised controlled trial of exogenous administration of melatonin in chronic pain (DREAM—CP): a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034443
Author(s):  
Rosalind Adam ◽  
Saravanakumar Kanakarajan ◽  
Uzunma Onyeakazi ◽  
Malachy Columb ◽  
Helen Galley
Keyword(s):  
Chronic Pain ◽  
Reaction Time ◽  
Sleep Disturbance ◽  
Pain Intensity ◽  
Treatment Period ◽  
Controlled Trial ◽  
Pain Clinic ◽  
Endogenous Opioid ◽  
Double Blind ◽  
Endogenous Opioid Peptide

IntroductionChronic pain is prevalent, and approximately half of patients with chronic pain experience sleep disturbance. Exogenous melatonin is licensed to treat primary insomnia and there is some evidence for analgesic effects of melatonin.The aim of this study is to investigate the effects of oral melatonin (as Circadin) 2 mg at night in adults with severe non-malignant pain of at least 3 months’ duration.Methods and analysisWe will conduct a randomised double-blind placebo-controlled cross-over study. The primary outcome is sleep disturbance. Secondary outcomes are pain intensity, actigraphy, fatigue, reaction time testing, serum melatonin and endogenous opioid peptide levels along with patient views about study participation.We aim to recruit 60 patients with severe chronic pain (average pain intensity ≥7 on the Brief Pain Inventory (BPI)) from a tertiary referral pain clinic in Northeast Scotland. Participants will be randomised to receive melatonin (as modified release Circadin) 2 mg daily for 6 weeks or placebo, followed by a 4-week washout period, then 6 weeks treatment with the treatment they did not receive. Participants will complete the Verran Snyder-Halpern Sleep Scale, Pittsburgh Sleep Quality Index, Pain and Sleep Questionnaire 3-item index, BPI and psychomotor vigilance reaction time testing at 6 points over 20 weeks. Actigraphy watches will be used to provide objective measures of sleep duration and latency and other sleep measures and will prompt patients to report contemporaneous pain and fatigue scores daily.Cross-over analyses will include tests for effects of treatment, period, treatment–period interaction (carryover effect) and sequence. Within-patient effects and longitudinal data will be analysed using mixed linear models, accounting for potential confounders.Ethics and disseminationApproved by Office for Research Ethics Committees Northern Ireland, reference 19/NI/0007. Results will be published in peer-reviewed journals and will be presented at national and international conferences.Trial registration numberISRCTN12861060

scholarly journals Improvements in Health-Related Quality of Life for Patients Treated with LentiGlobin for Sickle Cell Disease (bb1111) Gene Therapy

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 10-10
Author(s):  
Julie Kanter ◽  
John F. Tisdale ◽  
Markus Y Mapara ◽  
Janet L. Kwiatkowski ◽  
Lakshmanan Krishnamurti ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Pain Intensity ◽  
Physical Function ◽  
Board Of Directors ◽  
Sickle Cell ◽  
Research Funding ◽  
Pain Interference ◽  
Advisory Committees ◽  
Patient Reported ◽  
Population Norm

Background In patients with sickle cell disease (SCD), health-related quality of life (HRQoL) is worse than in the general population and comparable or worse than in patients with other chronic or painful diseases such as cystic fibrosis or cancer. Targeting SCD pathophysiology may significantly improve HRQoL in addition to clinical outcomes. In the ongoing phase 1/2 HGB-206 Study (NCT02140554), which evaluates the safety and efficacy of LentiGlobin for SCD (bb1111) gene therapy (GT), the most recently treated cohort of patients (Group C) have demonstrated improvements in laboratory assessments, including a trend toward normalization in key hemolysis markers and improvements in total hemoglobin values, and near resolution of vaso-occlusive crises and acute chest syndrome (ACS), suggesting a fundamental effect on sickle cell pathophysiology. Patient-reported HRQoL outcomes through 12 months post-treatment are presented here. Methods Patients (≥12 and ≤50 years of age) with SCD and history of stroke or severe vaso-occlusive events, including acute episodes of pain and ACS, were enrolled. CD34+ cells collected by plerixafor mobilization/apheresis were transduced with BB305 lentiviral vector. LentiGlobin was infused following myeloablative busulfan conditioning. In addition to laboratory and clinical assessments, patients were monitored for patient-reported outcomes (PROs) using the PRO Measurement Information System (PROMIS)-57. PROMIS-57 assesses HRQoL using collection of short forms containing 8 questions for each of the 7 PROMIS domains (Depression, Anxiety, Pain Interference, Fatigue, Sleep Disturbance, in which a lower score denotes improvement, and Physical Function, Satisfaction with Participation in Social Roles, in which a higher score denotes improvement) and a 0-10 Pain Intensity numeric rating scale (NRS). PROMIS-57 has been validated in patients with SCD. Data were analyzed for ten Group C patients who had at least 12 months of follow-up and had completed PROMIS-57 assessments as of March 3, 2020. For each domain, patients were stratified into 2 sub-groups based on baseline scores and population norm (i.e., baseline scores "better" than or near the population norm and baseline scores "worse" than the population norm). The stratification was built upon the premise that patients with baseline scores "better" or near the population norm would not be expected to improve. The US general population norm was 2.6 for Pain Intensity and a T-score of 50 for all other domains. The minimal clinically importance difference (2-point difference for pain intensity NRS and 5-point difference for other domains) was selected based on the PROMIS guidelines and literature. Results Patients who had baseline scores "worse" than the population norm reported improvements in all domains at Month 6, which were sustained through Month 12. These patients reported clinically meaningful improvement in 6/8 domains; mean T-scores at baseline and Month 12 were 6 and 2.4 for Pain Intensity (n=5); 63 and 48 for Pain Interference (n=7); 62 and 48 for Anxiety (n=3); 62 and 44 for Depression (n=4); 39 and 60 for Satisfaction with Social Roles (n=5); and 40 and 56 for Physical Function (n=4), respectively. Only 1 patient was included in the analysis of Fatigue and Sleep Disturbance domains, thereby limiting the conclusions in these 2 domains (Figure 1). Patients who had baseline scores that were "better" or near than the population norm reported clinically meaningful improvements in the Physical Function (n=6) and Fatigue domains (n=9); mean scores at baseline and Month 12 were 49 and 55 for Physical Function and 50 and 43 for Fatigue, respectively. Among patients in this sub-group, Pain Intensity (n=5) and Pain Interference (n=3) scores were stable from Month 6 through Month 12; there was no clinically meaningful change for the Anxiety (n=7) and Depression (n=6) domains, however, worsening was observed in the Satisfaction with Social Role (n=4) and Sleep Disturbance (n=9) domains (Figure 1). Summary LentiGlobin for SCD GT improved HRQoL in all domains of PROMIS-57 for patients whose baseline scores were "worse" than the population norm, including clinically meaningful improvements in all evaluable (6/8) domains. Larger sample sizes are required to clarify the impact of LentiGlobin for SCD for some PROMIS-57 domains. Disclosures Kanter: SCDAA Medical and Research Advisory Board: Membership on an entity's Board of Directors or advisory committees; AGIOS: Membership on an entity's Board of Directors or advisory committees; BEAM: Membership on an entity's Board of Directors or advisory committees; Jeffries: Honoraria; Cowen: Honoraria; Wells Fargo: Honoraria; NHLBI Sickle Cell Advisory Board: Membership on an entity's Board of Directors or advisory committees; bluebird bio, inc: Consultancy, Honoraria; Novartis: Consultancy; Sanofi: Consultancy; Medscape: Honoraria; Guidepoint Global: Honoraria; GLG: Honoraria. Kwiatkowski:Terumo Corp: Research Funding; Imara: Consultancy; Celgene: Consultancy; Agios: Consultancy; bluebird bio, Inc.: Consultancy, Research Funding; Novartis: Research Funding; Sangamo: Research Funding; Apopharma: Research Funding; Bristol Myers Squibb: Consultancy. Chen:bluebird bio, Inc.: Consultancy. Gallagher:bluebird bio, Inc.: Current Employment, Other: Ownership Interest and Salary. Ding:bluebird bio, Inc.: Current Employment, Other: Salary. Goyal:bluebird bio, Inc.: Current Employment, Other: Ownership Interest and Salary. Paramore:bluebird bio, Inc.: Current Employment, Other: Ownership Interest and Salary. Thompson:bluebird bio, Inc.: Consultancy, Research Funding; BMS: Consultancy, Research Funding; CRISPR/Vertex: Research Funding; Baxalta: Research Funding; Biomarin: Research Funding; Novartis: Consultancy, Honoraria, Research Funding. Walters:AllCells, Inc: Consultancy; Veevo Biomedicine: Consultancy; Editas: Consultancy.

scholarly journals Loneliness, social isolation, and pain following the COVID-19 outbreak: data from a nationwide internet survey in Japan

2021 ◽  
Author(s):  
Keiko Yamada ◽  
Kenta Wakaizumi ◽  
Yasuhiko Kubota ◽  
Hiroshi Murayama ◽  
Takahiro Tabuchi
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Social Isolation ◽  
Multinomial Logistic Regression ◽  
Short Form ◽  
Analysis Of Covariance ◽  
Internet Survey ◽  
Pain Prevalence ◽  
Pain History ◽  
Perceived Social Isolation

Abstract The aim of cross-sectional study was to investigate the association between pain and loneliness and increased social isolation during the COVID-19 pandemic. A total of 25,482 participants, aged 15–79 years, were assessed using an internet survey; the University of California, Los Angeles Loneliness Scale (Version 3), Short Form 3-item (UCLA-LS3-SF3) was used to assess loneliness, and a modified item of the UCLA-LS3-SF3 was used to measure the perception of increased social isolation during the pandemic. The outcome measures included the prevalence/incidence of pain (i.e., headache, neck or shoulder pain, upper limb pain, low back pain, and leg pain), pain intensity, and chronic pain history/prevalence. Pain intensity was measured by the pain/discomfort item of the 5-level version of the EuroQol 5 Dimension scale. Odds ratios of pain prevalence/incidence and chronic pain history/prevalence according to the UCLA-LS3-SF3 scoring groups (tertiles) and the frequency of the perceived increase in social isolation (categories 1–5) were calculated using multinomial logistic regression analysis. The mean pain intensity values among different loneliness and social isolation levels were tested using an analysis of covariance. Increased loneliness and the severity of the perceived social isolation were positively associated with pain prevalence/incidence, intensity, and the history/prevalence of chronic pain.

scholarly journals Association Between Baseline PROMIS Scores, Patient-Provider Communication Factors, and Musculoskeletal Health Literacy on Patient and Surgeon Expectations in Foot and Ankle Surgery

2020 ◽  
pp. 107110072095901
Author(s):  
Aoife MacMahon ◽  
Elizabeth A. Cody ◽  
Kristin Caolo ◽  
Jensen K. Henry ◽  
Mark C. Drakos ◽  
...  
Keyword(s):  
Health Literacy ◽  
Pain Intensity ◽  
Physical Function ◽  
Mental Status ◽  
Patient Perceptions ◽  
Pain Interference ◽  
Foot And Ankle ◽  
Musculoskeletal Health ◽  
Ankle Surgery ◽  
Patient Reported

Background: Various factors may affect differences between patient and surgeon expectations. This study aimed to assess associations between patient-reported physical and mental status, patient-surgeon communication, and musculoskeletal health literacy with differences in patient and surgeon expectations of foot and ankle surgery. Methods: Two hundred two patients scheduled to undergo foot or ankle surgery at an academic hospital were enrolled. Preoperatively, patients and surgeons completed the Hospital for Special Surgery Foot & Ankle Surgery Expectations Survey. Patients also completed Patient-Reported Outcomes Measurement Information System (PROMIS) scores in Physical Function, Pain Interference, Pain Intensity, Depression, and Global Health. Patient-surgeon communication and musculoskeletal health literacy were assessed via the modified Patients’ Perceived Involvement in Care Scale (PICS) and Literacy in Musculoskeletal Problems (LiMP) questionnaire, respectively. Results: Greater differences in patient and surgeon overall expectations scores were associated with worse scores in Physical Function ( P = .003), Pain Interference ( P = .001), Pain Intensity ( P = .009), Global Physical Health ( P < .001), and Depression ( P = .009). A greater difference in the number of expectations between patients and surgeons was associated with all of the above ( P ≤ .003) and with worse Global Mental Health ( P = .003). Patient perceptions of higher surgeons’ partnership building were associated with a greater number of patient than surgeon expectations ( P = .017). There were no associations found between musculoskeletal health literacy and differences in expectations. Conclusion: Worse baseline patient physical and mental status and higher patient perceptions of provider partnership building were associated with higher patient than surgeon expectations. It may be beneficial for surgeons to set more realistic expectations with patients who have greater disability and in those whom they have stronger partnerships with. Further studies are warranted to understand how modifications in patient and surgeon interactions and patient health literacy affect agreement in expectations of foot and ankle surgery. Level of Evidence: Level II, prospective comparative series.

scholarly journals Prevalence and Determinants of Pain and Pain-Related Disability in Urban and Rural Settings in Southeastern Ontario

2006 ◽  
Vol 11 (4) ◽  
pp. 225-233 ◽  
Author(s):  
Dean A Tripp ◽  
Elizabeth G VanDenKerkhof ◽  
Margo McAlister
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Status ◽  
Health Care Utilization ◽  
Pain Intensity ◽  
Pain Interference ◽  
Urban Region ◽  
Care Utilization ◽  
The Past ◽  
Pain Prevalence

BACKGROUND: Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES: To estimate chronic pain prevalence and factors associated with pain in southeastern Ontario, a region with a larger rural than urban residence.METHODS: A systematic sampling with a random start was used to contact households. A telephone-administered questionnaire using the Graded Chronic Pain Scale, with questions on health care and medication use, health status, depression and demographics, was administered to consenting adults (18 to 94 years of age; mean age 50.2±16.6 years).RESULTS: The response rate was 49% (1067 of 2167), with 76% reporting some pain over the past six months. Low pain intensity with low pain interference prevalence was 34% (grade I), high pain intensity with low pain interference was 26% (grade II), and high pain intensity with high pain interference was 17% (grades III and IV). Of those reporting pain, 49% reported chronic pain (ie, pain for a minimum of 90 days over the past six months) representing 37% of the sample. Being female, unmarried, lower income, poorer self-reported health status and rural residence were associated with increasing pain. Once depression was considered in this pain analysis, residence was no longer significant. Lower rates of health care utilization were reported by rural residents. In those reporting the highest pain grades, poor health, greater medication and health care use, depression and more pain sites were associated with higher odds for pain-related disability.CONCLUSION: There is an elevated prevalence of pain in this almost equally split rural/urban region. Further examination of health care utilization and depression is suggested in chronic pain prevalence research.

(532) Implications of pain interference on restoration of physical function for people with chronic pain

2015 ◽  
Vol 16 (4) ◽  
pp. S109
Author(s):  
N. Karayannis ◽  
M. Kao ◽  
R. Prasad ◽  
C. Cooley ◽  
S. Mackey
Keyword(s):  
Chronic Pain ◽  
Physical Function ◽  
Pain Interference

scholarly journals ODI Cannot Account for All Variation in PROMIS Scores in Patients With Thoracolumbar Disorders

2019 ◽  
Vol 10 (4) ◽  
pp. 399-405
Author(s):  
Peter G. Passias ◽  
Samantha R. Horn ◽  
Frank A. Segreto ◽  
Cole A. Bortz ◽  
Katherine E. Pierce ◽  
...  
Keyword(s):  
Linear Regression ◽  
Pain Intensity ◽  
Physical Function ◽  
Social Life ◽  
Thoracolumbar Spine ◽  
Pain Interference ◽  
Pain Intensity Score ◽  
Low Back ◽  
Patient Reported ◽  
The Relationship

Study Design: Retrospective review of single institution. Objective: To assess the relationship between Patient-Reported Outcomes Measurement Information System (PROMIS) and Oswestry Disability Index (ODI) scores in thoracolumbar patients. Methods: Included: Patients ≥18 years with a thoracolumbar spine condition (spinal stenosis, disc herniation, low back pain, disc degeneration, spondylolysis). Bivariate correlations assessed the linear relationships between ODI and PROMIS (Physical Function, Pain Intensity, and Pain Interference). Correlation cutoffs assessed patients with high and low correlation between ODI and PROMIS. Linear regression predicted the relationship of ODI to PROMIS. Results: A total of 206 patients (age 53.7 ± 16.6 years, 49.5% female) were included. ODI correlated with PROMIS Physical Function ( r = −0.763, P < .001), Pain Interference ( r = 0.800, P < .001), and Pain Intensity ( r = 0.706, P < .001). ODI strongly predicted PROMIS for Physical Function ( R2 = 0.58, P < .001), Pain Intensity ( R2 = 0.50, P < .001), and Pain Interference ( R2 = 0.64, P < .001); however, there is variability in PROMIS that ODI cannot account for. ODI questions about sitting and sleeping were weakly correlated across the 3 PROMIS domains. Linear regression showed overall ODI score as accounting for 58.3% ( R2 = 0.583) of the variance in PROMIS Physical Function, 63.9% ( R2 = 0.639) of the variance in Pain Interference score, and 49.9% ( R2 = 0.499) of the variance in Pain Intensity score. Conclusions: There is a large amount of variability with PROMIS that cannot be accounted for with ODI. ODI questions regarding walking, social life, and lifting ability correlate strongly with PROMIS while sitting, standing, and sleeping do not. These results reinforce the utility of PROMIS as a valid assessment for low back disability, while indicating the need for further evaluation of the factors responsible for variation between PROMIS and ODI.

The buffering role of positive affect on the association between pain intensity and pain related outcomes

2017 ◽  
Vol 14 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Ivan S.K. Thong ◽  
Gabriel Tan ◽  
Mark P. Jensen
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Negative Affect ◽  
Positive Affect ◽  
Pain Intensity ◽  
Sleep Problems ◽  
Cross Sectional Study ◽  
Pain Interference ◽  
Cross Sectional ◽  
The Impact

AbstractObjectivesChronic pain is a significant problem worldwide and is associated with significant elevations in negative affect, depressive symptoms, sleep problems, and physical dysfunction. Positive affect could potentially buffer the impact of pain on patient functioning. If it does, then positive affect could be directly targeted in treatment to benefit individuals with chronic pain. The purpose of this study was to test for such moderating effects.MethodsThis was a cross-sectional study, we administered measures of pain intensity, depressive symptoms, sleep problems, pain interference, and positive and negative affect to 100 individuals with chronic back or knee pain in a single face-to-face assessment session.ResultsThe associations between pain intensity and negative affect, and between pain intensity and depressive symptoms were moderated by positive affect. This moderation effect was explained by the fact that participants with low positive affect evidenced strong associations between pain intensity and both depression and negative affect; participants with high positive affect, on the other hand, evidenced weak and non-significant associations between pain intensity and both depression and negative affect. Positive affect did not moderate the associations between pain intensity and either sleep problems or pain interference.ConclusionThe findings are consistent with the possibility that positive affect may buffer the impact of pain intensity on negative affect and depressive symptoms. Longitudinal and experimental research is needed to determine the potential benefits of treatments that increase positive affect on negative affect and depressive symptoms in chronic pain populations.ImplicationsThe study findings suggest the possibility that “positive psychology” interventions which increase positive affect could benefit individuals with chronic pain by reducing the impact of pain on negative outcomes. Research to test this possibility is warranted.

scholarly journals An Empirical Classification of Chronic Pain Subgroups in Pediatric Sickle Cell Disease: A Cluster-Analytic Approach

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 491-491
Author(s):  
Soumitri Sil ◽  
Alison Manikowski ◽  
Mallory Schneider ◽  
Lindsey L Cohen ◽  
Carlton D. Dampier
Keyword(s):  
Chronic Pain ◽  
Cluster Analysis ◽  
Depressive Symptoms ◽  
Pain Intensity ◽  
Healthcare Utilization ◽  
Functional Outcomes ◽  
Clinical Characteristics ◽  
Pain Catastrophizing ◽  
Pain Interference ◽  
Pain Characteristics

Abstract Introduction: Youth with sickle cell disease (SCD) and chronic pain are a heterogeneous group with variability in their daily pain experience and physical and psychosocial functioning. We aimed to 1) empirically derive chronic pain subgroups based on sensory pain characteristics using cluster analysis within a sample of youth with chronic SCD pain, and 2) investigate derived subgroups for differences in sociodemographics, clinical characteristics, and psychosocial and functional outcomes. We hypothesized that chronic SCD pain subgroups with higher sensory pain experiences would be associated with poorer functional and psychosocial outcomes. Methods: Children and adolescents receiving care at comprehensive SCD clinics at three tertiary care locations within a southeast children's hospital were included if they were aged 10-18 years, any SCD genotype, reported chronic pain (i.e., pain on most days per month for a duration of at least 3 months), and had English fluency. Youth were excluded if they had comorbid medical conditions typically associated with pain but unrelated to SCD or had significant cognitive or developmental limitations that would interfere with study procedures. Patients completed a battery of patient-reported outcomes including pain characteristics (i.e., intensity, frequency, and the Adolescent Pediatric Pain Tool to assess number of pain locations and pain quality descriptors), PROMIS Pediatric Short Forms for pain interference, anxiety, and depressive symptoms, the Adolescent Sleep Wake Scale for sleep quality, and the Pain Catastrophizing Scale. Clinical characteristics and healthcare utilization outcomes were abstracted from electronic medical records including number of inpatient admissions for pain and emergency department visits for pain in the prior 12 months. Chronic SCD pain subgroups were based on sensory pain characteristics including pain intensity ratings, pain frequency, number of body sites affected by pain, and pain quality descriptors. Hierarchical cluster analysis informed the number of clusters at the patient level. K-means cluster analysis was used to assign patients to clusters once the number of clusters was established. Clusters were compared on sociodemographics, clinical characteristics, healthcare utilization, and child psychosocial and functional outcomes. Results: Youth (n=62) were on average (M) 13.9 years old (SD=2.5), 56% female, 95% Black or African American, and 85% Non-Hispanic/Latinx. Most (75%) had HbSS or HbSβ 0 and 67% were prescribed hydroxyurea. Hierarchical cluster analysis and k-means clustering supported a 2-cluster solution (see Figure 1). Cluster 1 (n=35; Frequent, Moderate Pain) was distinguished by significantly lower scores on worst pain intensity (M=6.4, SD=0.4), lower number of pain days per month (M=12.1, SD=2.8), fewer number of body sites affected by pain (M=8.9, SD=0.9), and lower pain quality ratings (M=15.9, SD=1.3). Cluster 2 (n=27; Almost Daily, High Pain) represented patients who reported high ratings of worst pain intensity (M=8.2, SD=0.3), daily to almost daily pain (M=20.3, SD=1.7), higher number of body sties affected by pain (M=12.5, SD=1.5), and higher ratings of pain quality (M=40.8, SD=1.9) (all p's &lt;.05). There were no differences between chronic SCD pain subgroups by sociodemographics (e.g., age, sex, family income), clinical characteristics (e.g., genotype, history of avascular necrosis, disease-modifying treatments, prescribed long-acting opioids, neuropathic medications, or antidepressants), or healthcare utilization. Patients in the Almost Daily High Pain subgroup reported significantly higher pain interference, depressive symptoms, and pain catastrophizing compared to patients in the Frequent, Moderate Pain subgroup (see Table 1). There were no differences between subgroups on anxiety or sleep quality. Conclusions: Two subgroups of chronic SCD pain were identified based on pain, psychosocial, and functional outcomes. Beyond sensory pain characteristics, pain interference, depressive symptoms, and pain catastrophizing were the only variables that best differentiated the chronic SCD pain subgroups. These empirically derived subgroups are comparable to other non-SCD chronic pain subgroups in pediatrics and adults. Identifying homogenous chronic SCD pain subtypes can inform tailored assessment and management of chronic pain. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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