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abstracts & posters

Behavioral health needs of patients with Sickle Cell Disease in the emergency department

key information

source: The Journal of Pain

year: 2014

authors: H. Williams, C. Freirmuth, D. Cline, J. Johnston, C. Rutherford, V. Thornton, P. Tanabe


One of the most difficult symptoms for persons with sickle cell disease (SCD) to manage is severe pain from vaso-occlusive crisis, which often require treatment in an emergency department (ED) setting. Many patients with SCD also experience depression and anxiety related to their vaso-occlusive crises, which can contribute to increases in pain severity and frequency. The objective of this study is to estimate the percentage of ED visits during which patients with SCD self-report anxiety or depression, and express a desire to have a social or behavioral health referral made during the same visit, as well as determine the percentage of social work and mental referrals made. To evaluate these outcomes, 120 interviews were conducted with 80 individual patients with SCD who received emergency care at one of two EDs over an 18-month period. Self-reported depression was indicated 31% of the 120 visits, while anxiety was reported during 29% of the visits. Patients stated that they were either receiving or enrolled in a behavioral health service during only 8% of the visits. During 23% of visits, patients indicated that it would have been helpful to receive a behavioral health referral. However, only three (.025%) behavioral health referrals were actually made. Patient reported during 39% of the visits that it would have been helpful to receive a social work referral, but only six (.05%) social work referrals were actually made. Because negative psychological states reinforce factors related to pain severity and frequency, it is vital that health care providers are not only aware of, but address the complex psychosocial needs of patients with SCD when providing pain management.

organization: Duke University, Durham, NC

DOI: 10.1016/j.jpain.2014.01.075

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