{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:37:01Z","timestamp":1783100221325,"version":"3.54.6"},"reference-count":64,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,12,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization. There is no standard protocol for management of an acute pain crisis in either the hospital or the community. The assumptions that severe acute pain must be managed in the hospital with parenteral opioids and that strong opioids are needed for home management of pain need to be questioned. Pain management in the emergency department often does not meet acceptable standards, while chronic use of strong opioids is likely to result in opioid-induced hyperalgesia, exacerbation of chronic pain symptoms, and opioid dependency. We suggest that an integrated approach is needed to control the underlying condition, modify psychological responses, optimize social support, and ensure that health care services provide safe, effective, and prompt treatment of acute pain and appropriate management of chronic pain. This integrated approach should begin at an early age and continue through the adolescent, transition, and adult phases of the care model.<\/jats:p>","DOI":"10.1182\/asheducation-2017.1.525","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T22:13:11Z","timestamp":1555452791000},"page":"525-533","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":15,"title":["Optimizing the care model for an uncomplicated acute pain episode in sickle cell disease"],"prefix":"10.1182","volume":"2017","author":[{"given":"Paul","family":"Telfer","sequence":"first","affiliation":[{"name":"Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"Kaya","sequence":"additional","affiliation":[{"name":"Departments of Haematology and Paediatric Haematology, Royal London Hospital, Bart\u2019s Health National Health Service Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"10","key":"2019111703190084600_B1","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1001\/jama.2014.10517","article-title":"Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members","volume":"312","author":"Yawn","year":"2014","journal-title":"JAMA"},{"key":"2019111703190084600_B2","unstructured":"National Institute of Health and Clinical Excellence. Management of an acute painful sickle cell episode in hospital. 2012; NICE Clinical Guideline 143. https:\/\/www.nice.org.uk\/guidance\/CG143. Accessed 1 April 2017."},{"issue":"1","key":"2019111703190084600_B3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJM199107043250103","article-title":"Pain in sickle cell disease. 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Hydroxyurea therapy in the management of sickle cell disease. In: Evidence-Based Management of Sickle Cell Disease. Expert Panel Report 2014. https:\/\/www.nhlbi.nih.gov\/health-pro\/guidelines\/sickle-cell-disease-guidelines. 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A sickle crisis? A report of National Confidential Enquiry into Patient Outcome and Death (2008). http:\/\/www.ncepod.org.uk\/2008report1\/Downloads\/Sickle_report.pdf. 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