Essay --

Title: Effectiveness of analgesia for pain management in patients with Sickle Cell Disease Introduction: Patient X was a 29-year-old male patient with Sickle Cell Disease (SCD). Aside from the complications associated with SCD such as opportunistic infections and vaso-occulsive episodes, which led to intense episodes of pain, he had no other co-morbidities. Patient X ran a family import business, which required frequent local and overseas travel. During the interview, Patient X repeatedly vocalized that the unpredictable onset and the manifestations of its symptoms was interfering with his quality of life in terms of economic cost (loss of business opportunities) and sleep. During acute episodes of pain, depending on its severity, Patient X would either contact his local GP for a prescription of painkillers or present himself at the Emergency Department (ED) to seek relief from his pain. SCD affects individuals with sub-Saharan African, Caribbean and Mediterranean ancestry. With a prevalence rate of more than 100,000 people in the United States alone and an incidence rate of 1 in 500 births among African-Americans, SCD is a major public health concern. (Givens et al. 2007, p. 239) Sickle Cell Pain (SCP) is a common feature in patients with SCD. It is characterised by episodes of severe pain. As pain management is primarily pharmaceutical in nature, the use of analgesia is of crucial importance in maintaining a patient’s quality of life. In SCP, the two major classes of analgesia used are non-steroidal anti-inflammatories (NSAIDS) and opioids. (See Table 1) First hand accounts from Patient X during interview in addition to a literature review which will be discussed later in this article highlights major psychosocial and medi... ... ED clinician attitudes, practice patterns as well as low addiction rates in this population should be highlighted to allow intervention. Following this, initiatives to improve ED management of acute sickle cell disease pain could promote more efficient ways to manage SCD pain, better dissemination of national guidelines, and efforts to improve negative physician attitudes toward SCD patients. Because of the complex nature of SCP, ideally there should be increased collaboration between front-line physicians such as the General practitioner and the Emergency Physician with subject matter specialists such as an Anaesthetist (to address acute and chronic pain management issues) and Haematologist (to treat the underlying pathophysiology of SCD). This multidisciplinary approach will not only to decrease adverse outcomes, but also increase the patient’s quality of life.