{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:43:18Z","timestamp":1760028198072,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T00:00:00Z","timestamp":1597449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5K23HL127100"],"award-info":[{"award-number":["5K23HL127100"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute pain events are a leading complication for sickle cell patients. In an attempt to improve pain outcomes, we developed an outpatient pain clinic, and included intranasal fentanyl in the opioid emergency department (ED) pain order set. We evaluated admission rates and opioid administration for patients that attended both the outpatient pain clinic and ED within a 3\u2010month period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recorded the admission rate, IV morphine equivalents, and time from triage for each opioid order and administration from both an outpatient pain clinic and ED visit within a 3\u2010month period for an individual pediatric patient with sickle cell disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty patients received acute pain management in both settings. We identified a significant reduction in hospital admission when patients received care in the pain clinic as compared to the ED (17% vs 43%, <jats:italic>P\u00a0=<\/jats:italic>\u00a0.02). Additionally, outpatient pain clinic patients received significantly less IV morphine equivalents than patients received in the ED (5.6 vs 10.6 IV morphine equivalents, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). In the ED, intranasal fentanyl was administered in a significantly shorter time than patients ordered intravenous opioid (43 vs 75\u00a0min, <jats:italic>P\u00a0=<\/jats:italic>\u00a0.02). The mean time to receiving an opioid in the outpatient pain clinic was 57\u00a0min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of an outpatient pain clinic can reduce admission rates as compared to the ED. The use of intranasal fentanyl reduced the time to first opioid administration in the ED. Patient\u2010centered research or quality improvement projects should continue to focus on novel approaches to acute pain event management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28648","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T08:30:13Z","timestamp":1597480213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Outpatient pain clinic and intranasal fentanyl to improve sickle cell disease outcomes"],"prefix":"10.1002","volume":"67","author":[{"given":"Raven","family":"Myrick","sequence":"first","affiliation":[{"name":"Children's of Alabama  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaundra","family":"Blakemore","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Waite","sequence":"additional","affiliation":[{"name":"Children's of Alabama  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandi","family":"Pernell","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avi","family":"Madan\u2010Swain","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Hilliard","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5011-1022","authenticated-orcid":false,"given":"Jeffrey","family":"Lebensburger","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2006.09.001"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10517"},{"issue":"2","key":"e_1_2_9_4_1","first-page":"62","article-title":"A quality improvement initiative to improve emergency department care for pediatric patients with sickle cell disease","volume":"21","author":"Treadwell MJ","year":"2014","journal-title":"J Clin Outcomes Manag"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e3182302871"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3470"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24534"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21483"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23961"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.07.037"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.05123.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2014.08.004"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-016-0432-0"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-13-74"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26332"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.11.015"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25144"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12313"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001018"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27525"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2018.10.006"}],"container-title":["Pediatric Blood &amp; 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