{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:02:26Z","timestamp":1784257346654,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,8,8]],"date-time":"2016-08-08T00:00:00Z","timestamp":1470614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health","award":["K23HL125984"],"award-info":[{"award-number":["K23HL125984"]}]},{"name":"National Institutes of Health, National Heart Lung and Blood Institute","award":["1R01HL078536"],"award-info":[{"award-number":["1R01HL078536"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:p>Pain, the hallmark complication of sickle cell disease (SCD), is largely managed with opioid analgesics in the United States, but comprehensive data regarding the long\u2010term use of opioids in this patient population is lacking. The pain medication prescription records from a cohort of 203 SCD patients were analyzed. Twenty\u2010five percent were not prescribed opioid medications while 47% took only short\u2010acting opioids, 1% took only long\u2010acting opioids, and 27% took a combination of short\u2010acting and long\u2010acting opioids. The median (interquartile range) daily opioid dose was 6.1 mg (1.7\u201326.3 mg) of oral morphine equivalents, which is lower than the published opioid use among patients with other pain syndromes. The dose of opioids correlated with the number of admissions due to vaso\u2010occlusive crisis (VOC) (<jats:italic>r<\/jats:italic>\u2009=\u20090.53, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). When the patients were grouped into quartiles based on daily dose opioid use, a logistic regression model showed that history of avascular necrosis (AVN) (OR: 2.87, 95% CI: 1.37\u20136.02, <jats:italic>P<\/jats:italic>\u2009=\u20090.005), 25\u2010OHD levels (OR: 0.59, 95% CI: 0.38\u20130.93, <jats:italic>P<\/jats:italic>\u2009=\u20090.024) and total bilirubin concentration (OR: 0.64, 95% CI: 0.42\u20130.99, <jats:italic>P<\/jats:italic>\u2009=\u20090.043) were independently associated with opioid use quartiles. In conclusion, doses and types of opioid medications used by adult SCD patients vary widely. Our findings implicate AVN and lower vitamin D levels as factors associated with higher opioid use. They also suggest an association of higher bilirubin levels, possibly suggesting higher hemolytic rate, with lower opioid use. Am. J. Hematol. 91:1102\u20131106, 2016. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24498","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T14:11:43Z","timestamp":1469715103000},"page":"1102-1106","source":"Crossref","is-referenced-by-count":35,"title":["Patterns of opioid use in sickle cell disease"],"prefix":"10.1002","volume":"91","author":[{"given":"Jin","family":"Han","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice College of Pharmacy, University of Illinois at Chicago Chicago Illinois"},{"name":"Comprehensive Sickle Cell Center, Section of Hematology\/Oncology, Department of Medicine, University of Illinois at Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh L.","family":"Saraf","sequence":"additional","affiliation":[{"name":"Comprehensive Sickle Cell Center, Section of Hematology\/Oncology, Department of Medicine, University of Illinois at Chicago 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