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Sickle Cell Disease

Sensory, Inflammatory, and Psychosocial Characteristics of Chronic Pain in Adolescents and Young Adults with Sickle Cell Disease

Researcher: Megan Coco, MSN APRN CPNP | APRN

Co-Investigators: Angela Starkweather, PhD ACNP-BC FAAN

Institution: University of Connecticut | Storrs, Connecticut

Grant Type: APHON Nursing Research Grant

Year Awarded: 2019


Abstract

Chronic pain is a significant problem in adolescents and young adults (AYA) with sickle cell disease (SCD), leading to a high pain burden and increased health care utilization. SCD is difficult to treat, with chronic opioids often used unsuccessfully and with many side effects. Many studies have shown a central mechanism involved in SCD chronic pain; additionally, neurochemical changes have been reported although none in the pediatric SCD chronic pain population. The purpose of this study is to describe and compare the sensory, inflammatory, and psychosocial profiles of AYA ages 12-21 with chronic SCD pain (AAPT subtypes - without contributory disease complications, with contributory disease complications and mixed pain types) and pain-free controls. We will enroll 30 AYA with chronic SCD pain in an outpatient hematology clinic and collect sensory (mechanical and thermal pain sensitivity), inflammatory (salivary interleukin (IL)-1, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-alpha) and psychosocial (functional pain burden with anxiety, depression, fatigue, functional status) data at a one-time point. Ten AYA without SCD chronic pain will be used as a comparison group. Biopsychosocial profiles of AYA with chronic SCD pain will be compared to pain-free AYA with SCD using student t-test with Bonferroni’s correction for multiple testing. Analysis of variance (ANOVA) will also be used to test for significant differences between the 3 subtypes of chronic SCD pain. The knowledge gained from this study will provide the first step toward more precise phenotyping of chronic pain in AYA with SCD, which may lead to the development of more mechanistically targeted strategies for SCD pain assessment and management as well as improvements in patient outcomes.

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