Smith, Meagan
(2012)
Web-based Monitoring of Pain Management in Adolescent and Young Adult Sickle Cell Patients Through Daily Self-Assessment.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
There is a wide range of variability in the clinical phenotype of Sickle Cell Disease (SCD), resulting in a vast array of clinical presentations ranging from acute, recurrent vaso-occlusive pain episodes to chronic pain, increased risk of strokes, acute chest syndromes and osteonecrosis. Historically, pain crises have been defined by whether or not the patient seeks medical attention. Previous studies have shown that while patients with SCD are in pain 54.5% of the time, they are only seeking medical attention during 3.5% of these episodes. This has led to a gross underestimation of the prevalence of pain episodes, due to discrepancies in both the definition and reporting of these episodes. There is currently no utility available to accurately assess and manage pain levels in Sickle Cell patients who are not utilizing medical facilities. The implementation of a web-based application to monitor daily pain levels is relevant to public health because it is likely to provide medical teams with the tools necessary to track patient pain levels more precisely. This will also enable healthcare providers to be more proactive with regard to pain management in patients with SCD.
Twenty-nine patients were asked to record their level of pain three times daily for six months via a web-based application. The application asked patients to appraise their pain level by use of a Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (extreme pain). Each patient was assigned a non-specific identifier that enabled him or her to log into the system
without referencing any personal health information. Pain measurements were electronically time stamped and all information was filtered to ensure the protection of patient sensitive information. Authorized team members were alerted of pain episodes by email (pain levels of 5-
7) or text message (pain levels of 8-10). The patient was then contacted and information was gathered regarding the location and duration of pain, the presence of other symptoms and social factors that influenced a patient’s decision to seek medical intervention.
Of the 29 patients enrolled in the study, 21 patients accessed the web-based application and provided a total of 4,981 pain data entries over a six month time period. Patients reported that they were in no pain (pain score of 0) 23.4% of the days logged, in pain (pain score of 1-7)
76.6% of the days logged and in pain crisis (pain score of 8-10) 12.2% of the days logged.
This data provides proof of the principle that adolescents with SCD will provide electronic reports of their pain multiple times a day over an extended period of time. This preliminary data also suggests that the prevalence of pain in adolescents is much greater than previously reported.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
2 July 2012 |
| Date Type: |
Publication |
| Defense Date: |
27 March 2013 |
| Approval Date: |
2 July 2012 |
| Submission Date: |
4 April 2012 |
| Access Restriction: |
1 year -- Restrict access to University of Pittsburgh for a period of 1 year. |
| Number of Pages: |
69 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Genetic Counseling |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
web-based application, Sickle Cell Disease, pain management |
| Date Deposited: |
02 Jul 2012 14:22 |
| Last Modified: |
15 Nov 2016 13:57 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/11695 |
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