{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:04:27Z","timestamp":1790121867474,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,10]],"date-time":"2017-11-10T00:00:00Z","timestamp":1510272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"This project was funded by the National Heart, Lung and Blood Institute","award":["R34 RHL121224A"],"award-info":[{"award-number":["R34 RHL121224A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Limited evidence guides opioid dosing strategies for acute Sickle Cell (SCD) pain. We compared two National Heart, Lung and Blood (NHBLI) recommended opioid dosing strategies (weight\u2010based vs. patient\u2010specific) for ED treatment of acute vaso\u2010occlusive episodes (VOE).<\/jats:p>\n                  <jats:p>\n                    A prospective randomized controlled trial (RCT) was conducted in two ED's. Adults \u2265 21 years of age with SCD disease were eligible. Among the 155 eligible patients, 106 consented and 52 had eligible visits. Patients were pre\u2010enrolled in the outpatient setting and randomized to one of two opioid dosing strategies for a future ED visit. ED providers accessed protocols through the electronic medical record. Change in pain score (0\u2010100 mm VAS) from arrival to ED disposition, as well as side effects were assessed. 52 patients (median age was 27 years, 42% were female, and 89% black) had one or more ED visits for a VOE (total of 126 ED study visits, up to 5 visits\/patient were included). Participants randomized to the patient\u2010specific protocol experienced a mean reduction in pain score that was 16.6 points greater than patients randomized to the weight\u2010based group (mean difference 95% CI\u2009=\u200911.3 to 21.9,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.03). Naloxone was not required for either protocol and nausea and\/or vomiting was observed less often in the patient\u2010specific protocol (25.8% vs 59.4%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.0001). The hospital admission rate for VOE was lower for patients in the patient\u2010specific protocol (40.3% vs 57.8%\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.05). NHLBI guideline\u2010based analgesia with patient\u2010specific opioid dosing resulted in greater improvements in the pain experience compared to a weight\u2010based strategy, without increased side effects.\n                  <\/jats:p>","DOI":"10.1002\/ajh.24948","type":"journal-article","created":{"date-parts":[[2017,10,19]],"date-time":"2017-10-19T03:02:59Z","timestamp":1508382179000},"page":"159-168","source":"Crossref","is-referenced-by-count":53,"title":["A randomized controlled trial comparing two vaso\u2010occlusive episode (VOE) protocols in sickle cell disease (SCD)"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9933-6425","authenticated-orcid":false,"given":"Paula","family":"Tanabe","sequence":"first","affiliation":[{"name":"Duke University School of Nursing and Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Silva","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing and Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden B.","family":"Bosworth","sequence":"additional","affiliation":[{"name":"Departments of Population Health Sciences Medicine, Psychiatry, and School of Nursing"},{"name":"Duke University, Center for Health Services Research in Primary Care Durham VAMC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Crawford","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Duke University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Paice","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Northwestern University; Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne D.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Professor and Vice Chair of Emergency Medicine Professor of Population Health Science &amp; Policy, Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher N.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Glassberg","sequence":"additional","affiliation":[{"name":"Hematology and Medical Oncology Associate Director of The Mount Sinai Comprehensive Sickle Cell Program Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,10]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Guideline for the Management of Acute and Chronic Pain in Sickle\u2010Cell Disease","author":"Benjamin LJ","year":"1999"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21807"},{"key":"e_1_2_7_4_1","unstructured":"ElixhauserA SteinerCA.Readmissions to U.S. Hospitals by Diagnosis 2010. Agency for Healthcare Research and Quality; August2013. Statistical Brief #153."},{"key":"e_1_2_7_5_1","unstructured":"HirschonJM.In: Tanabe P ed.Discussion of American College of Emergency Physicians Board Meeting discussion and approval of the Emergency Department Sickle Cell Care Coalition(EDSC3);2016."},{"key":"e_1_2_7_6_1","unstructured":"U.S. Department of Health and Human Services National Heart Lung and Blood Institute.Evidence\u2010Based Management of Sickle Cell Disease Expert Panel Report 2014;2014."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24198"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1740774513475850"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70238-X"},{"key":"e_1_2_7_10_1","volume-title":"Demystifying Opioid Conversion: A Guide for Effective Dosing","author":"McPherson M.","year":"2010"},{"key":"e_1_2_7_11_1","unstructured":"American Pain Society.Principles of Analgesic Use. 7th Edition Chicago IL;2016."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-05-647107"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.235"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.086637"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006565-199906000-00004"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2009.01.016"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(05)82929-4"},{"issue":"5","key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1182\/blood.V67.5.1442.1442","article-title":"A collaborative, double\u2010blind randomized study of cetiedil citrate in sickle cell crisis","volume":"67","author":"Benjamin L","year":"1986","journal-title":"Blood."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1991.00400070131017"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3470"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25024"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00693.x"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.24948","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.24948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T14:14:40Z","timestamp":1694700880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.24948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,10]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1002\/ajh.24948"],"URL":"https:\/\/doi.org\/10.1002\/ajh.24948","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,10]]}}}