{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:08:11Z","timestamp":1789495691587,"version":"build-2803163510"},"reference-count":61,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T00:00:00Z","timestamp":1387756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Chronic pain, most often due to haemophilic arthropathy, is a pervasive problem in persons with haemophilia (<jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content>) that adversely impacts function and quality of life. <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> with inhibitors and older <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> may be especially vulnerable to progressive arthropathy and resulting chronic pain. The development of chronic pain from acute pain involves a complex interplay of biological and psychosocial factors that may all contribute to the perpetuation of chronic pain and the outcome of therapy. In the absence of evidence\u2010based guidelines, an individualized, multimodal approach to chronic pain management is proposed, as it is in individuals without haemophilia who have chronic pain. Pharmacological treatment is central to the management of chronic pain and must be modified based on pain intensity, ongoing response to therapy and the risk for adverse events. Non\u2010pharmacological interventions, including physiotherapy, complementary treatments and surgical (e.g. orthopaedic) or other invasive procedures, may be integral to chronic pain management in this population. Ongoing psychosocial assessment is critical to identify those factors that may be contributing to the perpetuation of chronic pain or acting as barriers to effective management. Additional study is needed to identify optimal pharmacological treatments for chronic pain in <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> based on the unique pathophysiology of haemophilic arthropathy and on risk profile. Systematic determination of the particular psychosocial factors impacting the experience and management of chronic pain in <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> would likewise add value to the treatment of this pervasive problem.<\/jats:p>","DOI":"10.1111\/hae.12349","type":"journal-article","created":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T08:54:41Z","timestamp":1387788881000},"source":"Crossref","is-referenced-by-count":48,"title":["Comprehensive management of chronic pain in haemophilia"],"prefix":"10.1111","volume":"20","author":[{"given":"G.","family":"Young","sequence":"first","affiliation":[{"name":"Hemostasis and Thrombosis Center Children's Hospital Los Angeles Keck School of Medicine University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Tachdjian","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Allergy David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Baumann","sequence":"additional","affiliation":[{"name":"Center for Bleeding and Clotting Disorders University of Minnesota Fairview Medical Center Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Panopoulos","sequence":"additional","affiliation":[{"name":"Fairview Pain Management Center University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08919.x"},{"key":"e_1_2_8_3_1","first-page":"CD003420","article-title":"Clotting factor concentrates given to prevent bleeding and bleeding\u2010related complications in people with hemophilia A or B","volume":"9","author":"Iorio A","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.9.s1.2.x"},{"key":"e_1_2_8_5_1","first-page":"161","article-title":"Chronic arthropathy management in haemophilia: assessing the impact of a new model of care","volume":"125","author":"d'Young I","year":"2012","journal-title":"N Z Med J"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02808.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2001.00540.x"},{"issue":"3","key":"e_1_2_8_8_1","first-page":"177","article-title":"Quality of life (QOL) and well\u2010being of hemophilia patients and parents managing hemophilia: HERO study analysis","volume":"18","author":"Garrido C","year":"2012","journal-title":"Haemophilia"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02709.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2006.01203.x"},{"issue":"4","key":"e_1_2_8_11_1","first-page":"136","article-title":"Factors associated with health\u2010related quality of life in hemophilia A patients around the world","volume":"16","author":"Blanchette V","year":"2010","journal-title":"Haemophilia"},{"issue":"3","key":"e_1_2_8_12_1","first-page":"70","article-title":"Burden of joint disability in hemophilia A and hemophilia B patients","volume":"18","author":"Cyhaniuk A","year":"2012","journal-title":"Haemophilia"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06490.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-05-1457"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2006.01204.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-03-0941"},{"issue":"3","key":"e_1_2_8_17_1","first-page":"178","article-title":"A comparison of pediatric hemophilia patients with and without inhibitors in the US: assessment of health\u2010related quality of life and joint outcomes","volume":"18","author":"Poon J","year":"2012","journal-title":"Haemophilia"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02440.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-215665"},{"key":"e_1_2_8_20_1","unstructured":"Schulz\u2010GibbinsC.Psychological Evaluation of the Patient with Chronic Pain. 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