12/7/09 - Connecticut Children’s Physician Publishes Commentary On Sickle Cell Pain In Internationally Recognized Medical Journal
HARTFORD, Conn.—Trust and justice need to be instilled into the care of patients with sickle cell disease who require treatment for the severe pain that is the hallmark of this disease. Concerns about drug abuse, reluctance to prescribe opioids and the disbelief of a patient’s report of pain severity are major barriers in treating those with sickle cell pain according to an article published by William T. Zempsky, MD, professor of pediatrics at the University of Connecticut School of Medicine and the associate director of the Pain Relief Program at Connecticut Children’s Medical Center. Dr. Zempsky’s article is published in the Dec. 9 edition of the Journal of the American Medical Association (JAMA).
“Evidence of inadequate attention to sickle cell pain abounds in the literature and is most noted in patients as they reach adulthood,” wrote Dr. Zempsky. “Patients who present frequently to the emergency department are at the highest risk for inadequate attention; those who treat most of their pain at home are often vulnerable as well. This is at least in part due to a negative attitude toward patients with sickle cell disease and a profound fear of catering to opioid addiction.”
Dr. Zempsky added that this reluctance on the caregiver’s part is often a dangerous barrier to properly managing the patient’s sickle cell pain. From the patient standpoint, these interactions with the health care system perpetuate a long history of distrust and injustice between providers and those with the disease. Dr. Zempsky noted that evidence suggests that opioid addiction in patients with sickle cell disease occurs less frequently than less than popular opinion would suggest.
But Dr. Zempsky said there is hope to better improve the injustice provided to these patients.
“A model of care strengthening communication between the patient’s medical home and the emergency department, either in real time or through the use of individualized protocols, should be encouraged,” wrote Dr. Zempsky, who even suggested the use of a “pain passport” which would allow the patient’s pain plan to be given to clinicians that would validate the request for specific treatment.
JAMA is the most widely circulated medical journal in the world and has been published continuously since 1883. JAMA is an international peer-reviewed general medical journal that is published 48 times per year.
