source: Blood Advances

year: 2017

authors: Fitzhugh CD, Walters MC

Sickle cell disease (SCD) is the most commonly inherited blood disorder in North America, and impacts approximately 100 000 people in the United States (US). Affected individuals generally live on average 30 years less than the general population. These individuals suffer acute, intermittent painful episodes (vaso‐occlusive crisis [VOC]), as well as fatigue, chronic organ damage and chronic pain.

Currently, the National Heart Lung and Blood Institute and Centers for Disease Control and Prevention recommend aggressive treatment with opioids during acute VOC and as a therapeutic option for chronic pain. Despite these guideline recommendations for aggressive opioid treatment for acute pain in SCD, the high opioid doses often used for SCD‐related pain may result in a negative perception of affected persons by some healthcare professionals.

Additionally, the current national opioid crisis is impacting overall opioid prescribing including for the SCD population. Despite the critical need for and concerns about opioid‐based pain management, there is limited evidence on current opioid treatment patterns among individuals with SCD and any potential link to the U.S. opioid epidemic.

This study aims to describe opioid utilization in individuals with SCD within the context of healthcare utilization, and the U.S. opioid epidemic among a published broader U.S. population. Since individuals with SCD are likely to have public health insurance coverage, and literature suggests that utilization (including opioid use) may differ between privately and publicly insured indidviduals, our study examined utilization in both commercially‐insured individuals and those with Medicaid coverage.

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