Timely administration of analgesia in the emergency department (ED) to patients with sickle cell disease (SCD) per American Society of Hematology (ASH) guidelines achieves pain goals faster and leads to better outcomes than when analgesia is not provided as quickly, according to a study published in the Journal of Pain & Palliative Care Pharmacotherapy.

The researchers recommend the administration of analgesia within 60 minutes of ED arrival, per the ASH guidelines, for improved patient outcomes.

“In our study, when the first dose of analgesia was administered within the guideline-recommended 60 minutes of ED arrival, pain reduction goals were achieved faster in patients with SCD,” the authors wrote. “While this study did not assess long-term outcomes, timely pain relief is likely still a highly desirable outcome for individual patients experiencing acute sickle-cell-related pain.”

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The research team retrospectively assessed 233 encounters with patients with SCD who were administered analgesia for acute pain crises between January 2019 and December 2019. The encounters were classified based on receiving pain medication within 60 minutes of arrival in the ED, as recommended by ASH guidelines.

The main outcome measure was a reduction of ≥30% in patient-reported pain scores on a 10-point scale, and factors influencing the administration of analgesia were also assessed.

Those patients receiving analgesia within 60 minutes had a significantly faster reduction in pain, had a shorter stay in the ED, and they required less morphine milligram equivalents than those who did not receive analgesia as quickly. Those patients with documented substance abuse disorders were less likely to receive timely analgesia than other patients.

The authors recommend increased provider education as well as the standardization of treatment approaches for patients with SCD to reduce time in the ED and improve overall outcomes.

Reference

Seaser J, Thomson J, Brunsman A, et al. Evaluation of guideline-recommended pain management in acute sickle cell crisis and its effect on patient outcomes. J Pain Palliat Care Pharmacother. Published online June 29, 2022. doi:10.1080/15360288.2022.2084209