Managing Chronic Complications of Sickle Cell Disease: Evidence-Based Management of Sickle Cell Disease | oneSCDvoice
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guides & guidelines

Managing Chronic Complications of Sickle Cell Disease: Evidence-Based Management of Sickle Cell Disease

key information

source: National Heart, Lung, and Blood Institute (U.S.)

year: 2014

summary/abstract:

Recommendations:

Determine the cause and type of SCD-related chronic pain. This includes chronic pain with objective signs such as avascular necrosis (AVN) and leg ulcers, and chronic pain without objective signs due to neuroplasticity of the peripheral or central nervous system. (Consensus–Adapted)

Use a combination of the patient’s response to treatment—including pain relief, side effects, and functional outcomes—to guide the long-term use of opioids. (Consensus–Adapted)

Encourage people to use deep tissue/deep pressure massage therapy, muscle relaxation therapy, and self-hypnosis as indicated. (Weak Recommendation, Low-Quality Evidence)

Use long- and short-acting opioids to manage chronic pain that is not relieved by nonopioids. (Consensus–Adapted) Assess all people with SCD for chronic pain annually or more often as needed. This assessment should include descriptors of the pain; its severity on a numerical scale; its location; factors that precipitate or relieve it, including biopsychosocial factors; and its effect on the patient’s mood, activity, employment, quality of life, and vital signs. (Consensus–Adapted)

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