title: Pain in thalassaemia: the effects of age on pain frequency and severity.
abstract: Pain is not a symptom generally associated with thalassaemia. However, providers have noted increasing patient reports of pain, creating an impetus for this prospective, observational assessment of pain in thalassaemia patients. The primary study goals were to assess pain prevalence, severity, location, and potential risk factors. This was a multicentre, prospective study of thalassaemia patients receiving care at 12 Thalassaemia Clinical Research Network sites. Pain was assessed using the Brief Pain Inventory. Two hundred and fifty-two thalassaemia patients ranging in age from 12 to 71 years (mean 28.8) were enrolled. Sixty-four per cent reported experiencing pain during the last 4 weeks, 22% of whom reported pain on a daily basis. Ordinal regression analysis of pain ratings demonstrated significant (P < 0.001) correlation of increased age with increased pain, irrespective of diagnosis, transfusion status, gender, bone density, chelator type or iron overload. Eighty-one per cent reported having pain for 1 year or longer and 31% reported pain for five or more years. Pain is a major cause of morbidity and an unrecognized problem for patients with thalassaemia. Age is the strongest predictor of frequency and severity. Little else is known about the aetiology and predictors of this pain syndrome.
authors.affiliation: Hematology/Oncology Department, Children's Hospital & Research Center Oakland, Oakland, CA 94609, USA. dfoote@mail.cho.org
authors.forename: Dru
authors.initials: D
authors.lastname: Haines
authors.forename: Marie
authors.initials: M
authors.lastname: Martin
authors.forename: Susan
authors.initials: S
authors.lastname: Carson
authors.forename: Olivia
authors.initials: O
authors.lastname: Oliveros
authors.forename: Sage
authors.initials: S
authors.lastname: Green
authors.forename: Thomas
authors.initials: T
authors.lastname: Coates
authors.forename: Jennifer
authors.initials: J
authors.lastname: Eile
authors.forename: Leann
authors.initials: L
authors.lastname: Schilling
authors.forename: Bogan
authors.initials: B
authors.lastname: Dinu
authors.forename: Tito
authors.initials: T
authors.lastname: Mendoza
authors.forename: Eric
authors.initials: E
authors.lastname: Gerstenberger
authors.forename: Felicia
authors.initials: F
authors.lastname: Trachtenberg
authors.forename: Elliott
authors.initials: E
authors.lastname: Vichinsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D002648:Child; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood; D007502:Iron Chelating Agents / Q000627:therapeutic use; D019190:Iron Overload / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D013789:Thalassemia / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D065227:Transfusion Reaction; D055815:Young Adult; D017085:alpha-Thalassemia / Q000453:epidemiology
chemical_list: D000700:Analgesics; D006454:Hemoglobins; D007502:Iron Chelating Agents; D007501:Iron