Papers of the Week

Chronic pain affects 30-40% of individuals with sickle cell disease (SCD) and impairs patient functioning. Clinically meaningful, practical, and valid assessment tools for investigation, evaluation and management of chronic pain are limited, representing a barrier for advancing SCD care. We sought to determine whether patient-reported outcomes (PROs) show preliminary construct validity in identifying individuals with SCD who were a priori defined as suggestive of having chronic pain based on previously published criteria. All individuals completed PROMIS domains Pain Interference, Pain Behavior, Pain Quality (Nociceptive, Neuropathic), Fatigue, Sleep Disturbance, Depression, Anxiety; ASCQ-Me domains Pain Impact and Emotional Impact; and painDETECT questionnaire. Thirty-three adults living with SCD were enrolled, 42.4% had chronic pain. Pain-related PROs scores distinctly differentiated individuals with chronic pain from those without. Individuals with chronic pain had significantly worse pain-related PROs scores: PROMIS Pain Interference 64.2 vs 54.3, p<0.001, PROMIS Pain Behavior 63.2 vs 50, p=0.004, ASCQ-Me Pain Impact 42.9 vs 53.2, p=0.013. According to published PROMIS clinical cut scores for the pain-related domains, individuals with chronic pain were categorized as having moderate impairment, while those without chronic pain had mild or no impairment. Individuals with chronic pain had PRO pain features consistent with neuropathic pain and worse scores in Fatigue, Depression, Sleep Disturbance and Emotional Impact. Pain-related PROs show preliminary construct validity in differentiating individuals with and without chronic SCD pain and could be used as valuable tools for research and clinical monitoring of chronic pain.