{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:16:06Z","timestamp":1791134166434,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T00:00:00Z","timestamp":1699747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["1UG3\/UH3 \u2010HL137856"],"award-info":[{"award-number":["1UG3\/UH3 \u2010HL137856"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U24HL137907"],"award-info":[{"award-number":["U24HL137907"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vaso\u2010occlusive crises (VOCs) cause debilitating pain and are a common cause of emergency department (ED) visits, for people with sickle cell disease (SCD). Strategies for achieving optimal pain control vary widely despite evidence\u2010based guidelines. We tested existing guidelines and hypothesized that a patient\u2010specific pain protocol (PSP) written by their SCD provider may be more effective than weight\u2010based (WB) dosing of parenteral opiate medication, in relieving pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a prospective, randomized controlled trial comparing a PSP versus WB protocol for patients presenting with VOCs to six EDs. Patients were randomized to a PSP or WB protocol prior to an ED visit. The SCD provider wrote their protocol and placed it in the electronic health record for future ED visits with VOC exclusion criteria that included preexisting PSP excluding parenteral opioid analgesia or outpatient use of buprenorphine or methadone or highly suspected for COVID\u201019. Pain intensity scores, side effects, and safety were obtained every 30\u2009min for up to 6\u2009h post\u2013ED bed placement. The primary outcome was change in pain intensity score from placement in an ED space to disposition or 6\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 328 subjects were randomized; 104 participants enrolled (ED visit, target\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009230) with complete data for 96 visits. The study was unable to reach the target sample size and stopped early due to the impact of COVID\u201019. We found no significant differences between groups in the primary outcome; patients randomized to a PSP had a shorter ED length of stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), and the prevalence of side effects was low in both groups. Subjects in both groups experienced both a clinically meaningful and a statistically significant decrease in pain (27\u2009mm on a 0\u2010 to 100\u2010mm scale).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found a shorter ED length of stay for patients assigned to a PSP. Patients in both groups experienced good pain relief without significant side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.14805","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T21:45:52Z","timestamp":1695246352000},"page":"1210-1222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A comparison of the effect of patient\u2010specific versus weight\u2010based protocols to treat vaso\u2010occlusive episodes in the emergency department"],"prefix":"10.1111","volume":"30","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 School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Ibemere","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing  Durham North Carolina USA"},{"name":"Duke Global Health Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-4765","authenticated-orcid":false,"given":"Ava E.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline E.","family":"Freiermuth","sequence":"additional","affiliation":[{"name":"Emergency Medicine University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden B.","family":"Bosworth","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center Durham, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)  Durham North Carolina USA"},{"name":"Departments of Population Health Sciences, School of Medicine, Department of Psychiatry and Behavioral Sciences, School of Nursing Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqui","family":"Yang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifeyinwa","family":"Osunkwo","sequence":"additional","affiliation":[{"name":"Atrium Health, Levine Cancer Institute, Sickle Cell Disease Enterprise  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Paxton","sequence":"additional","affiliation":[{"name":"Emergency Medicine Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Strouse","sequence":"additional","affiliation":[{"name":"Department of Medicine and Pediatrics Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-1359","authenticated-orcid":false,"given":"Joseph","family":"Miller","sequence":"additional","affiliation":[{"name":"Emergency Medicine Detroit Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Paice","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padmaja","family":"Veeramreddy","sequence":"additional","affiliation":[{"name":"Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia L.","family":"Kavanagh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Gentry","family":"Wilkerson","sequence":"additional","affiliation":[{"name":"Emergency Medicine University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hughes","sequence":"additional","affiliation":[{"name":"Emergency Medicine Case Western Reserve University School of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiman X.","family":"Barnhart","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine, Duke Molecular Physiology Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001851"},{"key":"e_1_2_10_3_1","unstructured":"Evidence\u2010Based Management of Sickle Cell Disease Expert Panel Report 2014.U.S. Department of Health and Human Services National Institutes of Health National Heart Lung and Blood Institute.2014. 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