Frequently asked questions by hospitalists managing pain in adults with sickle cell disease

• Published in: Journal of hospital medicine Vol. 6; no. 5; pp. 297 - 303
• Main Authors: Smith, Wally R., Jordan, Lanetta B., Hassell, Kathryn L.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.05.2011
• Subjects: Adult; Analgesics, Opioid - therapeutic use; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - drug therapy; Disease Management; hematology; Hospitalists - methods; Hospitalization - trends; Humans; multidisciplinary care; pain; Pain - drug therapy; Pain - etiology; Pain Measurement - drug effects; Pain Measurement - methods; quality improvement; sickle cell disease; Substance-Related Disorders - prevention & control
• ISSN: 1553-5592; 1553-5606
• DOI: 10.1002/jhm.933

Pain is the predominant medical presentation to hospitalists for patients with sickle cell disease (SCD). Dramatic treatment gains of SCD in childhood have resulted in more adults now requiring hospitalization than children. This has created new challenges to improve the quality of hospital care for SCD. The evidence base for pain management in SCD is lacking. We therefore offer some evidence and our informed opinion to answer frequently asked questions (FAQs) about pain management by hospitalists caring for adults with SCD. The most common questions center around defining a crisis; selecting and managing opioids; distinguishing between opioid tolerance, physical dependence, and addiction or misuse; determining appropriateness of discharge; and avoiding lengthy or recurrent hospitalizations. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.