Predictive factors of daily opioid use and quality of life in adults with sickle cell disease. Hematology 2018 Dec;23(10):856-863
Date
06/01/2018Pubmed ID
29848208DOI
10.1080/10245332.2018.1479997Scopus ID
2-s2.0-85047906072 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
OBJECTIVES: In adults with sickle cell disease (SCD), pain often necessitates opioid use. Few studies have examined the relationship between opioid use and health-related quality of life (HRQOL) in adults with SCD. We tested the hypothesis that higher doses of opioids are associated with worse HRQOL.
METHODS: A cross-sectional cohort study was performed in adults with SCD who completed standardized and validated HRQOL questionnaires: Patient Health Questionnaire-15 (PHQ-15), Patient Health Questionnaire-9 (PHQ-9), Medical Outcome Study 36 Item Short Form (SF-36), and Generalized Anxiety Disorder questionnaire (GAD-7). Daily outpatient opioid dose was converted into morphine milligram equivalents (MME) and categorized as < 90 mg/day or ≥ 90 mg/day. Subject's questionnaire scores were compared by opioid dose.
RESULTS: Ninety-nine adults completed questionnaires. The majority had HbSS and median age was 30 years. The median MME was 80 mg/day. When the association between HRQOL and opioid dose was compared, those prescribed ≥ 90 MME had significantly lower SF-36 subscale scores in 7 of 8 domains, and significantly higher severity scores in the PHQ-15, GAD-7, and the PHQ-9 in comparison those prescribed < 90 MME. Using a multivariable regression tree analysis, in addition to the presence of chronic pain, mental health, physical health, and somatic burden were key predictors of ≥ 90 MME opioid use.
CONCLUSION: Higher daily opioid dose is associated with chronic pain. Among those with chronic pain, opioid dose ≥ 90 MME is associated with worse HRQOL.
Author List
Karafin MS, Singavi A, Hussain J, Wandersee N, Heinrich T, Hurley RW, Zhang L, Simpson P, Field JJAuthors
Joshua J. Field MD Professor in the Medicine department at Medical College of WisconsinThomas W. Heinrich MD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of Wisconsin
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAnemia, Sickle Cell
Anxiety Disorders
Chronic Pain
Cross-Sectional Studies
Female
Humans
Male
Morphine
Quality of Life
Surveys and Questionnaires