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American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain.

Publication ,  Journal Article
Brandow, AM; Carroll, CP; Creary, S; Edwards-Elliott, R; Glassberg, J; Hurley, RW; Kutlar, A; Seisa, M; Stinson, J; Strouse, JJ; Yusuf, F ...
Published in: Blood Adv
June 23, 2020

BACKGROUND: The management of acute and chronic pain for individuals living with sickle cell disease (SCD) is a clinical challenge. This reflects the paucity of clinical SCD pain research and limited understanding of the complex biological differences between acute and chronic pain. These issues collectively create barriers to effective, targeted interventions. Optimal pain management requires interdisciplinary care. OBJECTIVE: These evidence-based guidelines developed by the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in pain management decisions for children and adults with SCD. METHODS: ASH formed a multidisciplinary panel, including 2 patient representatives, that was thoroughly vetted to minimize bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including updating or performing systematic reviews. Clinical questions and outcomes were prioritized according to importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment. RESULTS: The panel reached consensus on 18 recommendations specific to acute and chronic pain. The recommendations reflect a broad pain management approach, encompassing pharmacological and nonpharmacological interventions and analgesic delivery. CONCLUSIONS: Because of low-certainty evidence and closely balanced benefits and harms, most recommendations are conditional. Patient preferences should drive clinical decisions. Policymaking, including that by payers, will require substantial debate and input from stakeholders. Randomized controlled trials and comparative-effectiveness studies are needed for chronic opioid therapy, nonopioid therapies, and nonpharmacological interventions.

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Published In

Blood Adv

DOI

EISSN

2473-9537

Publication Date

June 23, 2020

Volume

4

Issue

12

Start / End Page

2656 / 2701

Location

United States

Related Subject Headings

  • United States
  • Humans
  • Hematology
  • Evidence-Based Medicine
  • Chronic Pain
  • Child
  • Anemia, Sickle Cell
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
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Brandow, A. M., Carroll, C. P., Creary, S., Edwards-Elliott, R., Glassberg, J., Hurley, R. W., … Lang, E. (2020). American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain. Blood Adv, 4(12), 2656–2701. https://doi.org/10.1182/bloodadvances.2020001851
Brandow, Amanda M., C Patrick Carroll, Susan Creary, Ronisha Edwards-Elliott, Jeffrey Glassberg, Robert W. Hurley, Abdullah Kutlar, et al. “American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain.Blood Adv 4, no. 12 (June 23, 2020): 2656–2701. https://doi.org/10.1182/bloodadvances.2020001851.
Brandow AM, Carroll CP, Creary S, Edwards-Elliott R, Glassberg J, Hurley RW, et al. American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain. Blood Adv. 2020 Jun 23;4(12):2656–701.
Brandow, Amanda M., et al. “American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain.Blood Adv, vol. 4, no. 12, June 2020, pp. 2656–701. Pubmed, doi:10.1182/bloodadvances.2020001851.
Brandow AM, Carroll CP, Creary S, Edwards-Elliott R, Glassberg J, Hurley RW, Kutlar A, Seisa M, Stinson J, Strouse JJ, Yusuf F, Zempsky W, Lang E. American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain. Blood Adv. 2020 Jun 23;4(12):2656–2701.

Published In

Blood Adv

DOI

EISSN

2473-9537

Publication Date

June 23, 2020

Volume

4

Issue

12

Start / End Page

2656 / 2701

Location

United States

Related Subject Headings

  • United States
  • Humans
  • Hematology
  • Evidence-Based Medicine
  • Chronic Pain
  • Child
  • Anemia, Sickle Cell
  • 3201 Cardiovascular medicine and haematology