A prospective study of high-impact chronic pain in sickle cell disease: the Sickle Pain-Related Impact (SPiRIt) study

Area of Science:

• Sickle Cell Disease Research
• Chronic Pain Management
• Psychological Impact of Pain

Background:

• High-impact chronic pain (HICP) significantly restricts daily activities in sickle cell disease (SCD), but its risk factors and outcomes are poorly understood.
• The Sickle Pain-Related Impact (SPiRIt) study addresses this knowledge gap by prospectively examining HICP in young adults with SCD.

Purpose of the Study:

• To investigate the characteristics and risk factors associated with high-impact chronic pain (HICP) in individuals with sickle cell disease (SCD).
• To compare outcomes between patients with HICP and mild-bothersome chronic pain (MBCP) in SCD.
• To explore the longitudinal course of HICP in SCD.

Main Methods:

• Prospective longitudinal study (SPiRIt) of 90 individuals with SCD (aged 16-40) reporting pain at baseline (T1) and 70 at 6 months (T2).
• Assessment of pain burden, functional outcomes, pain catastrophizing, fear of movement, self-efficacy, and chronic pain acceptance.
• Categorization into high-impact chronic pain (HICP) and mild-bothersome chronic pain (MBCP) groups.

Main Results:

• Participants with HICP reported greater pain, worse outcomes, higher pain catastrophizing, fear of movement, and lower self-efficacy and pain acceptance compared to MBCP.
• Pain catastrophizing was associated with increased odds of HICP, while self-efficacy and pain acceptance were associated with decreased odds.
• Approximately 56% of participants with T1 and T2 data were in a longitudinal high-risk group, with pain catastrophizing at T1 predicting higher odds of being in this group.

Conclusions:

• Individuals with SCD experiencing HICP face significant morbidity and poorer outcomes.
• Psychological factors, including pain catastrophizing, self-efficacy, and pain acceptance, play a crucial role in the development and persistence of HICP in SCD.
• HICP in SCD may be a dynamic state, necessitating further longitudinal research to identify risk factors for sustained HICP and long-term adverse outcomes.