Outpatient Pain Predicts Subsequent One-Year Acute Health Care Utilization Among Adults With Sickle Cell Disease

Abstract Context Patient demographic and clinical factors have known associations with acute health care utilization (AHCU) among patients with sickle cell disease (SCD), but it is unknown if pain measured predominantly in an outpatient setting is a predictor of future AHCU in patients with SCD. Obj...

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Bibliographic Details
Published in:Journal of pain and symptom management 2014-07, Vol.48 (1), p.65-74
Main Authors: Ezenwa, Miriam O., PhD, RN, Molokie, Robert E., MD, Wang, Zaijie Jim, PhD, Yao, Yingwei, PhD, Suarez, Marie L., PhD, Angulo, Veronica, BA, Wilkie, Diana J., PhD, RN, FAAN
Format: Article
Language:English
Subjects:
acute health care utilization
Adolescent
Adult
adults
Aged
Anemia, Sickle Cell - physiopathology
Anemia, Sickle Cell - therapy
Anemias. Hemoglobinopathies
Anesthesia & Perioperative Care
At risk
Biological and medical sciences
Composite Pain Index
Demographic aspects
Diseases of red blood cells
Emergency Medical Services - utilization
Female
gender
Helpseeking
Hematologic and hematopoietic diseases
Humans
Male
Measurement
Medical sciences
Middle Aged
outpatient pain
Outpatients
Pain
Pain - physiopathology
Pain Management
Pain Measurement
Pain Medicine
Patient Acceptance of Health Care
Pharmacology. Drug treatments
Sickle cell anaemia
Sickle cell disease
Surveys and Questionnaires
Time Factors
Treatment Outcome
Young Adult
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Summary:Abstract Context Patient demographic and clinical factors have known associations with acute health care utilization (AHCU) among patients with sickle cell disease (SCD), but it is unknown if pain measured predominantly in an outpatient setting is a predictor of future AHCU in patients with SCD. Objectives To determine whether multidimensional pain scores obtained predominantly in an outpatient setting predicted subsequent 1-year AHCU by 137 adults with SCD and whether the pain measured at a second visit also predicted AHCU. Methods Pain data included the Composite Pain Index (CPI), a single score representative of a multidimensional pain experience (number of pain sites, intensity, quality, and pattern). Based on the distribution of AHCU events, we divided patients into three groups: 1) zero events (zero), 2) 1 to 3 events (low), or 3) 4 to 23 events (high). Results The initial CPI scores differed significantly by the three groups ( F (2,134) = 7.38, P  = 0.001). Post hoc comparisons showed that the zero group had lower CPI scores than both the low ( P  
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2013.08.020