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Blood, 1 February 2008, Vol. 111, No. 3, pp. 997-1003. Prepublished online as a Blood First Edition Paper on October 16, 2007; DOI 10.1182/blood-2007-07-089144. This Article Full Text Full Text (PDF) Supplemental Appendices and Table All Versions of this Article: blood-2007-07-089144v1 111/3/997    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Solomon, L. R. Search for Related Content PubMed PubMed Citation Articles by Solomon, L. R. Related Collections Perspectives Red Cells Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  PERSPECTIVE Treatment and prevention of pain due to vaso-occlusive crises in adults with sickle cell disease: an educational void Lawrence R. Solomon1 1 Adult Sickle Cell Disease Program, Section of Hematology, Department of Medicine, Yale University School of Medicine, New Haven, CT Pain due to vaso-occlusive crisis is the major cause of hospital use in sickle cell disease. Although available guidelines provide recommendations for opioid administration in this setting, only 4 (21%) of 19 medical textbooks present treatment regimens that are consistent with them. Moreover, only 7 texts (37%) note that addiction is infrequent in this population, while 11 (92%) of 12 texts provide such reassurance for cancer-related pain (P < .005). Finally, hydroxyurea use to decrease the frequency of vaso-occlusive crises is completely defined only in 2 textbooks. Thus, most medical texts provide neither adequate information for the treatment or prevention of pain due to vaso-occlusive crisis in sickle cell disease nor reassurance of the unlikelihood of addiction in this population. In contrast, treatment recommendations for less common hematologic disorders are consistent with current standards in 53% to 84% of appropriate texts (P < .05). Limited knowledge regarding the principles and appropriateness of opioid therapy; a lack of evidence-based research on pain control; and misconceptions and prejudices about drug abuse and addiction contribute to this educational void. Thus, research and training on pain control in sickle cell disease are needed to parallel studies of environmental and genetic factors contributing to the known clinical heterogeneity of this disorder. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: P. Bartolucci, T. El Murr, F. Roudot-Thoraval, A. Habibi, A. Santin, B. Renaud, V. Noel, M. Michel, D. Bachir, F. Galacteros, et al. A randomized, controlled clinical trial of ketoprofen for sickle-cell disease vaso-occlusive crises in adults Blood, October 29, 2009; 114(18): 3742 - 3747. [Abstract] [Full Text] [PDF]

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