title: Psychosocial and pharmacological management of pain in pediatric sickle cell disease.
abstract: For children with sickle cell disease (SCD), pain is associated with significant current and future morbidity and mortality. Unfortunately, few evidence-based guidelines exist for the management of pain episodes in children with SCD. To inform empirically based treatment strategies for pain management in pediatric SCD, this review integrates and evaluates the extant literature on psychosocial and pharmacological approaches to the management of pain. Findings reveal a paucity of rigorous investigations of psychosocial and pharmacological pain management interventions in children with SCD. Psychosocial interventions included were primarily cognitive-behavioral in nature, whereas pharmacological approaches targeted non-opioid analgesics (ie, nonsteroidal anti-inflammatory drugs and corticosteroids) and opioid medications (ie, morphine and oxycodone). However, to date there is not a "gold standard" for pain management among children with SCD. Because psychosocial and physiological processes each play a role in the etiology and experience of pain, effective pain management requires multidimensional, comprehensive treatment approaches. Considering the significant impact of pain on functional outcomes and quality of life among children with SCD, additional clinical trials are warranted to ensure that interventions are safe and efficacious.
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA. akh38@drexel.edu.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Hildenbrand
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Nicholls
authors.forename: Brian P
authors.initials: BP
authors.lastname: Daly
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Marsac
authors.forename: Reem
authors.initials: R
authors.lastname: Tarazi
authors.forename: Raybagkar
authors.initials: R
authors.lastname: Deepti
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000523:psychology / Q000628:therapy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D059408:Pain Management / Q000379:methods* / Q000523:psychology; D010147:Pain Measurement
chemical_list: D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents