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scientific articles

Predictive factors of daily opioid use and quality of life in adults with sickle cell disease

key information

source: Hematology

year: 2018

authors: Karafin MS, Singavi A, Hussain J, Wandersee N, Heinrich T, Hurley RW, Zhang L, Simpson P, Field JJ


In adults with sickle cell disease (SCD), pain often necessitates opioid use. Few studies have examined the relationship between opioid use and health-related quality of life (HRQOL) in adults with SCD. We tested the hypothesis that higher doses of opioids are associated with worse HRQOL.

A cross-sectional cohort study was performed in adults with SCD who completed standardized and validated HRQOL questionnaires: Patient Health Questionnaire-15 (PHQ-15), Patient Health Questionnaire-9 (PHQ-9), Medical Outcome Study 36 Item Short Form (SF-36), and Generalized Anxiety Disorder questionnaire (GAD-7). Daily outpatient opioid dose was converted into morphine milligram equivalents (MME) and categorized as < 90 mg/day or >= 90 mg/day. Subject’s questionnaire scores were compared by opioid dose.

Ninety-nine adults completed questionnaires. The majority had HbSS and median age was 30 years. The median MME was 80 mg/day. When the association between HRQOL and opioid dose was compared, those prescribed >= 90 MME had significantly lower SF-36 subscale scores in 7 of 8 domains, and significantly higher severity scores in the PHQ-15, GAD-7, and the PHQ-9 in comparison those prescribed < 90 MME. Using a multivariable regression tree analysis, in addition to the presence of chronic pain, mental health, physical health, and somatic burden were key predictors of >= 90 MME opioid use.

Higher daily opioid dose is associated with chronic pain. Among those with chronic pain, opioid dose >= 90 MME is associated with worse HRQOL.

organization: BloodCenter of Wisconsin, USA; Medical College of Wisconsin, USA; University of Illinois, USA; Wake Forest School of Medicine, USA

DOI: 10.1080/10245332.2018.1479997

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