title: Frequently asked questions by hospitalists managing pain in adults with sickle cell disease.
abstract: 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.
authors.affiliation: Division of General Internal Medicine, Adult Sickle Cell Program, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA. wrsmith@vcu.edu
authors.forename: Wally R
authors.initials: WR
authors.lastname: Smith
authors.forename: Lanetta B
authors.initials: LB
authors.lastname: Jordan
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Hassell
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000755:Anemia, Sickle Cell / Q000150:complications / Q000188:drug therapy*; D019468:Disease Management; D020445:Hospitalists / Q000379:methods*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods*; D019966:Substance-Related Disorders / Q000517:prevention & control
chemical_list: D000701:Analgesics, Opioid