Pediatric sickle cell: resident attitudes lead to undertreatment for pain

  • Fearon A & al.
  • Pediatr Blood Cancer
  • 1 Nov 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Attitudes among pediatric residents toward patients with sickle cell disease (SCD) lead to undertreatment for pain.

Why this matters

  • "Current guidelines recommend high-priority treatment of severe [SCD] pain with opioids," say researchers. "[R]esidents that we surveyed reported concerns about tolerance and dependence as major barriers to use of opioids in treatment of acute pain in SCD."

Study design

  • Researchers surveyed residents at an urban pediatric medical center (N=53) about acute SCD pain management, classifying them as either "more experienced" (had seen ≥21 patients with SCD; 45.3%) or "less experienced."
  • Funding: NIH.

Key results

  • Both more and less experienced residents reported that potential tolerance and dependence were major barriers to opioid use in SCD.
  • A greater need for additional training in SCD pain management (P<.05 was reported by less experienced residents as were concern about addiction and greater empathy for patients with scd>

Limitations

  • The study was single-center with a small sample size.
  • The surveys were subject to self-reporting bias.

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