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Daily Assessment of Pain in Adults with Sickle Cell Disease

Wally R. Smith, MD; Lynne T. Penberthy, MD, MPH; Viktor E. Bovbjerg, PhD, MPH; Donna K. McClish, PhD; John D. Roberts, MD; Bassam Dahman, MS; Imoigele P. Aisiku, MD, MSCR; James L. Levenson, MD; and Susan D. Roseff, MD
[+] Article and Author Information

From Virginia Commonwealth University, Richmond, and University of Virginia, Charlottesville, Virginia.


Grant Support: By the National Heart, Lung, and Blood Institute (1R01HL64122-01A1).

Potential Financial Conflicts of Interest:Consultancies: W.R. Smith (Purdue Pharma). Grants received: W.R. Smith (National Heart, Lung, and Blood Institute), L.T. Penberthy (National Heart, Lung, and Blood Institute), D.K. McClish (National Heart, Lung, and Blood Institute), I.P. Aisiku (National Heart, Lung, and Blood Institute), S.D. Roseff (National Heart, Lung, and Blood Institute). Grants pending: W.R. Smith (National Heart, Lung, and Blood Institute), L.T. Penberthy (National Heart, Lung, and Blood Institute).

Requests for Single Reprints: Wally R. Smith, MD, Division of Quality Health Care, Department of Internal Medicine, Virginia Commonwealth University, Box 980306, Richmond, VA 23298; e-mail, wrsmith@vcu.edu.

Current Author Addresses: Drs. Smith and Penberthy and Mr. Dahman: Virginia Commonwealth University, 1200 East Broad Street, Room W10W-402, Richmond, VA 23298.

Dr. Bovbjerg: University of Virginia, Box 800717, Charlottesville, VA 22908.

Dr. McClish: Virginia Commonwealth University, 1101 East Marshall Street, Richmond, VA 23298.

Dr. Roberts: Virginia Commonwealth University, 401 College Street, Richmond, VA 23298.

Dr. Aisiku: Virginia Commonwealth University, 401 North 12th Street, Richmond, VA 23298.

Dr. Levenson: Virginia Commonwealth University, Box 980268, Richmond, VA 23298.

Dr. Roseff: Virginia Commonwealth University School of Medicine, 1200 East Marshall Street, Richmond, VA 23298.

Author Contributions: Conception and design: W.R. Smith, L.T. Penberthy, V.E. Bovbjerg, D.K. McClish, J.D. Roberts, B. Dahman, J.L. Levenson.

Analysis and interpretation of the data: W.R. Smith, L.T. Penberthy, V.E. Bovbjerg, D.K. McClish, J.D. Roberts, I. Aisiku, B. Dahman, J.L. Levenson, S.D. Roseff.

Drafting of the article: W.R. Smith, L.T. Penberthy, V.E. Bovbjerg, D.K. McClish, B. Dahman, J.L. Levenson.

Critical revision of the article for important intellectual content: W.R. Smith, L.T. Penberthy, V.E. Bovbjerg, D.K. McClish, I. Aisiku, B. Dahman, J.L. Levenson, S.D. Roseff.

Final approval of the article: W.R. Smith, L.T. Penberthy, V.E.

Provision of study materials or patients: W.R. Smith, J.D. Roberts.

Statistical expertise: D.K. McClish, B. Dahman.

Obtaining of funding: W.R. Smith, D.K. McClish, J.D. Roberts.

Administrative, technical, or logistic support: S.D. Roseff.

Collection and assembly of data: W.R. Smith, B. Dahman.


Ann Intern Med. 2008;148(2):94-101. doi:10.7326/0003-4819-148-2-200801150-00004
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Three hundred eight patients enrolled in PiSCES and completed baseline surveys. Twenty-three patients (7.5%) sent in no diaries. Of the remaining 285 patients, we excluded 53 (19%) because they completed fewer than 30 diaries. The remaining 232 patients constitute the analysis sample. Patients in the analysis sample were similar to those excluded except for age; the patients who did not complete sufficient diaries tended to be younger (mean age, 28.3 years vs. 32.6 years; P = 0.012). We included a total of 31 017 diaries (patient-days) in this analysis. The median number of diaries completed was 158, about 85% of the diaries requested. When patients were grouped by the number of diaries submitted (30 to 59, 60 to 90, and so on), we found no statistically significant differences among groups in terms of pain, crisis, or utilization.

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Figure.
Breakdown of diary days.

Total diary days (n = 31 017) are reported by percentage in 4 mutually exclusive categories of pain severity, and mean pain intensity is reported by category. Percentages of days in each category are unadjusted for repeated measures within patients. Mean pain intensity scores are adjusted.

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Summary for Patients

Pain and Health Care Visits in Patients with Sickle Cell Disease

The summary below is from the full report titled “Daily Assessment of Pain in Adults with Sickle Cell Disease.” It is in the 15 January 2008 issue of Annals of Internal Medicine (volume 148, pages 94-101). The authors are W.R. Smith, L.T. Penberthy, V.E. Bovbjerg, D.K. McClish, J.D. Roberts, B. Dahman, I.P. Aisiku, J.L. Levenson, and S.D. Roseff.

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