Journal of opioid management · 2026
Assessment of a standardized pain management protocol for adult patients with sickle cell disease.
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Dayer Lindsey E, Makhoul Issam, Montgomery Collin, Wilson Leigh Ann, Council Sarah, Bowers Stella, Harrington Sarah E, Lakkad Mrinmayee, Saccente Suzanne, Painter Jacob T
Аннотация
OBJECTIVE: To evaluate the impact of a standardized pain management protocol on prescribing practices for opioids, nonopioid therapies, and disease-modifying agents among adult patients with sickle cell disease (SCD) in an outpatient setting.
DESIGN: A retrospective analysis comparing prescribing patterns before and after the implementation of a standardized pain management protocol.
SETTING: An adult sickle cell clinic at an academic medical center.
PATIENTS/PARTICIPANTS: A total of 165 adult patients diagnosed with SCD receiving outpatient care.
INTERVENTIONS: Implementation of a multidisciplinary team-developed standardized pain management protocol for assessing and managing pain and psychological distress in patients with SCD.
MAIN OUTCOME MEASURE(S): Changes in opioid prescribing patterns (including median morphine equivalent daily dose [MEDD]), prescribing of nonopioid therapies, eg, antidepressants, anticonvulsants, nonsteroidal anti-inflammatory drug (NSAIDs), prescribing of disease-modifying agents (hydroxyurea), and pain scores.
RESULTS: Following protocol implementation, the proportion of patients prescribed opioids decreased to 91.5 percent (p = 0.03). Although no significant change occurred in median MEDD, prescribing of nonopioid therapies significantly increased, including hydroxyurea (57.5 percent vs 21.2 percent, p < 0.01), antidepressants, anticonvulsants, and NSAIDs. Pain scores decreased slightly but not significantly.
CONCLUSIONS: The standardized outpatient pain management protocol has the potential to reduce opioid usage and increase the adoption of evidence-based nonopioid therapies in patients with SCD. Further validation in diverse clinical settings is warranted to assess the protocol's long-term effectiveness and outcomes.
DESIGN: A retrospective analysis comparing prescribing patterns before and after the implementation of a standardized pain management protocol.
SETTING: An adult sickle cell clinic at an academic medical center.
PATIENTS/PARTICIPANTS: A total of 165 adult patients diagnosed with SCD receiving outpatient care.
INTERVENTIONS: Implementation of a multidisciplinary team-developed standardized pain management protocol for assessing and managing pain and psychological distress in patients with SCD.
MAIN OUTCOME MEASURE(S): Changes in opioid prescribing patterns (including median morphine equivalent daily dose [MEDD]), prescribing of nonopioid therapies, eg, antidepressants, anticonvulsants, nonsteroidal anti-inflammatory drug (NSAIDs), prescribing of disease-modifying agents (hydroxyurea), and pain scores.
RESULTS: Following protocol implementation, the proportion of patients prescribed opioids decreased to 91.5 percent (p = 0.03). Although no significant change occurred in median MEDD, prescribing of nonopioid therapies significantly increased, including hydroxyurea (57.5 percent vs 21.2 percent, p < 0.01), antidepressants, anticonvulsants, and NSAIDs. Pain scores decreased slightly but not significantly.
CONCLUSIONS: The standardized outpatient pain management protocol has the potential to reduce opioid usage and increase the adoption of evidence-based nonopioid therapies in patients with SCD. Further validation in diverse clinical settings is warranted to assess the protocol's long-term effectiveness and outcomes.