Sickle cell disease (SCD) patients’ pain frequency is influenced by employment status, depression, sex, and age, according to a cross-sectional study of 2,000 SCD patients. Almost half of those studied reported frequent pain, defined as four or more pain crises in 12 months, and age, sex, employment status, and depression were found to impact pain frequency and severity. The study found that educational attainment and income did not increase pain episodes’ frequency or severity. Females were significantly associated with increased frequency and severity of pain, while participants below the age of 18 were inversely linked to pain frequency and severity. Unemployed patients’ pain frequency and severity increased compared to employed patients, with depression significantly associated with increased pain frequency. While pain medication was associated with increased pain frequency and severity, daily use of pain medicines increased the frequency and severity of pain, whereas hydroxyurea and regular blood transfusions had no association.
The study included 2,264 SCD patients aged between 15 and 45, with over half identifying as female (56.2%) and 95.5% of Black ethnicity. The majority of patients reported their highest level of education as a high school diploma or lower, coupled with low annual household incomes.
The study raised concerns about the current approach to treating SCD-related pain. Harris et al. came to the conclusion that SCD-related pain should not be treated with medications only but should include holistic, comprehensive approaches to relieve pain. Additionally, they considered pain interventions’ screening regarding depression and mental health challenges in SCD patients. Depression was significantly associated with increased pain frequency, which is particularly important considering SCD’s disproportionate impact on individuals of African descent and Black youth with SCD’s stigma. Limitations to treatment for pain further compounded this issue.
The study further identified discrepancies in how depression is diagnosed and reported in SCD patients. Medical records for SCD patients underreport depression status. Researchers recommend using a patient combined with the medical record to provide more accurate measurements.
In conclusion, there is a need to address concerns raised in this study as employers will need to consider the psychological factors of sickle-cell patients, particularly when it concerns pain. Additionally, medical providers need to consider holistic treatments that address the physical and both mental, and social aspects of pain management in patients with SCD. In addressing these concerns, stakeholders can work towards developing policies that meet the needs of sickle-cell patients better.
