Adolescents and Young Adults With Sickle Cell Disease: Nociplastic Pain and Pain Catastrophizing as Predictors of Pain Interference and Opioid Consumption.
Adolescents and Young Adults With Sickle Cell Disease: Nociplastic Pain and Pain Catastrophizing as Predictors of Pain Interference and Opioid Consumption.
复制标题
患有镰状细胞病的青少年和年轻人：伤害性疼痛和疼痛灾难化作为疼痛干扰和阿片类药物消耗的预测因素。
DOI：
10.1097/ajp.0000000000001119
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
LavoieSmith,EllenM
中科院分区：
文献类型：
--
作者：
Kuisell,Clare;Ploutz-Snyder,Robert;Williams,DavidA;Voepel-Lewis,Terri;Hutchinson,RaymondJ;Dudding,KatherineM;Bridges,Celia;LavoieSmith,EllenM
目的：镰状细胞病（SCD）的部分患者具有伤害性疼痛的特征。虽然研究表明，许多伤害性疼痛患者由于阿片类药物无反应性而消耗更多的阿片类药物，但对伤害性疼痛和疼痛灾难化对青少年和年轻成人（AYA）SCD患者阿片类药物消耗和疼痛干扰的影响知之甚少。本研究的目的是（1）描述伤害性疼痛和疼痛灾难性的AYA与SCD之间，（2）确定这些特征是否与随后的阿片类药物的消费和疼痛干扰1个月后characterization.Methods：参与者完成了调查，在常规的临床访问（基线）的伤害性疼痛和灾难性的特征。此后，参与者每周收到一次短信，其中包括疼痛干预和阿片类药物消费调查。多预测因子2部分模型被用来评估基线特征和随后的疼痛干扰，阿片类药物consumption.Results：四十八AYA年龄在14至35完成基线测量之间的预测关系。25%的参与者有提示伤害性疼痛的评分。更大的伤害性疼痛特征显着增加了服用阿片类药物的几率（比值比= 1.2），并具有更大的疼痛干扰（比值比= 1.46）。回归分析发现，更大的基线伤害性疼痛特征与阿片类药物消耗（β= 0.13）和疼痛干扰（β= 0.061）显著相关;而更高的疼痛灾难性评分预测阿片类药物消耗（β =− 0.03）和疼痛干扰（β=− 0.0007）。了解SCD患者的伤害性疼痛特征可能更好地指导个体化疼痛管理。
Objectives:Some patients with sickle cell disease (SCD) have features of nociplastic pain. While research suggests that many patients with nociplastic pain consume more opioids due to opioid nonresponsiveness, little is known about the impact of nociplastic pain and pain catastrophizing on opioid consumption and pain interference among adolescents and young adults (AYA) with SCD. The purpose of this study was to (1) characterize nociplastic pain and pain catastrophizing among AYA with SCD, and (2) determine whether these characterizations are associated with subsequent opioid consumption and pain interference 1 month after characterization.Methods:Participants completed surveys characterizing nociplastic pain and catastrophizing at a routine clinic visit (baseline). Thereafter, participants received weekly text messages that included pain interference and opioid consumption surveys. Multipredictor 2-part models were used to evaluate the predictive relationships between baseline characterizations and subsequent pain interference, and opioid consumption.Results:Forty-eight AYA aged 14 to 35 completed baseline measures. Twenty-five percent of participants had scores suggestive of nociplastic pain. Greater nociplastic pain features significantly increased the odds of consuming opioids (odds ratio= 1.2) and having greater interference from pain (odds ratio= 1.46). Regression analyses found that greater baseline nociplastic pain characteristics were significantly associated with opioid consumption (β= 0.13) and pain interference (β= 0.061); whereas higher pain catastrophizing scores predicted less opioid consumption (β=− 0.03) and less pain interference (β=− 0.0007).Discussion:In this sample of AYA with SCD, features of nociplastic pain predicted higher subsequent opioid consumption and pain interference. Being aware of nociplastic pain features in patients with SCD may better guide individualized pain management.