Patient self-assessment of hospital pain, mood and health-related quality of life in adults with sickle cell disease

BMJ Open. 2012 Jul 2;2(4):e001274. doi: 10.1136/bmjopen-2012-001274. Print 2012.


Introduction: Acute pain is a hallmark of sickle cell disease (SCD) for which frequent hospital admissions may be required, affecting the quality of life of patients.

Objectives: To characterise the relationship between adult patient self-reported sickle cell pain, mood and quality of life during and after hospital admissions.

Design: Longitudinal study across three time-points.

Setting: Secondary care, single specialist sickle cell centre.

Participants: 510 adult patients with SCD admitted to hospital daycare or inpatient units.

Outcome measures: Self-assessments of pain, mood and health-related quality of life with health utility (measured on the EQ-5D) on admission, before discharge and at 1-week postdischarge.

Results: Mood, general health and quality of life showed significant steady improvements with reduction of pain in patients with SCD on admission to hospital, before discharge and at 1-week follow-up (p<0.01). Health utility scores derived from the EQ-5D showed a negative association with pain in regression analysis over the three time-points.

Conclusion: Examining health-related quality of life and health utility in relation to pain during hospital admissions is valuable in terms of targeting appropriate psychological interventions within the context of a multidisciplinary approach to managing sickle cell pain. This has implications for healthcare costs.