Impact of Individualized Versus Weight-Based Pain Protocols on Patient Satisfaction for Patients With Sickle Cell Disease Experiencing a Vaso-Occlusive Episode.

This is a secondary analysis of patient satisfaction, and the study was not powered to infer relationships or make assessments for the larger sickle cell disease population. Only 101 of the 328 consented and randomized participants had a usable emergency department study visit after exclusions, so the analyzed sample was much smaller than the randomized sample. The study was done in academic centers with hematologists and emergency departments with trial resources, which may not apply to hospitals with fewer resources or less experience with sickle cell disease. Four of the five satisfaction questions had not been psychometrically validated, although they had been used in sickle cell disease populations. There was no comparison with baseline or standard-care pain satisfaction; the research team considered that unethical because of known poor emergency department satisfaction for vaso-occlusive episodes.

Authors declared multiple relationships. NIH/NHLBI-related research support was reported, including support from the NIH Pragmatic Trials Collaboratory funded by several NIH Institutes and Centers and the NHLBI. Other declared relationships included honoraria from St. Jude's Children's Hospital and the University of Tennessee Health Sciences Center; consulting for CSL Behring, Esperion, Imatar, Novartis, Sanofi, Vidya, Walmart, Webmed, Janssen, Disc Medicine, Editas Medicine, and the National Foundation of Emergency Medicine; research support from BeBetter Therapeutics, Boehringer Ingelheim, Esperion, Improved Patient Outcomes, Merck, NHLBI, Novo Nordisk, Otsuka, Sanofi, Veterans Administration, Elton John Foundation, Hilton Foundation, Pfizer, Regeneron, Eli Lilly, BioAge, CoapTech, Global Blood Therapeutics, Novartis, CalciMedica, Endpoint Health, Blade Therapeutics, Janssen, ProvePharma, Roche, Beckton Dickinson, Tonix, Vapotherm, Abbott, Siemens, Beckman Coulter, Gilead, Agois Pharmaceuticals, National Institute of Neurological Disorders and Stroke, Centers for Disease Control, American Society of Hematology, North Carolina Department of Health and Human Services, National Heart, Lung and Blood Institute, and National Institutes of Health; compensation from Prova Education and Prime Education; and four authors had no disclosures.

Do not conclude that individualized protocols improve pain relief or patient satisfaction overall. The pain-score comparison was null, and only one secondary satisfaction item favored individualized protocols; most satisfaction questions did not differ.