Pain in Children and Adolescents With Sickle Cell Disease: An Analysis of Daily Pain Diaries

The purpose of this study was to analyze daily patterns of pain, medication use, health care use, and activity reduction during pain episodes in children and adolescents with sickle cell disease (SCD). The parents of 34 children and adolescents ages 6 to 17 years completed a daily diary about their children's pain response for 14 days. Eight of the adolescents (ages 13-17) concurrently but independently completed the same diaries. The results indicate that children with SCD usually experienced low levels of pain that was managed at home, sometimes without any medications. Multilevel random effects models indicated that as pain levels increased, children were more likely to use narcotic medications and health care services, although overall health care utilization during the 2-week period tended to be relatively infrequent. On average, children considerably reduced school, household, and social activities when in pain. Moreover, parents and adolescents generally agreed on daily pain response, especially for salient events such as health care visits.