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Review
. 2021 Oct;133(19-20):1042-1056.
doi: 10.1007/s00508-020-01798-4. Epub 2021 Mar 4.

Pain management in hemophilia: expert recommendations

Waltraud Stromer  1 , Ingrid Pabinger  2 , Cihan Ay  2 , Richard Crevenna  3 , Josef Donnerer  4 , Clemens Feistritzer  5 , Sophie Hemberger  6 , Rudolf Likar  7   8   9 , Florian Sevelda  10 , Katharina Thom  6 , Barbara Wagner  3 , Werner Streif  11
Affiliations
Review

Pain management in hemophilia: expert recommendations

Waltraud Stromer et al. Wien Klin Wochenschr. 2021 Oct.

Abstract

Introduction: As a typical consequence of bleeding into muscles and joints, patients with severe hemophilia suffer from acute and chronic pain. In spite of its high prevalence, pain in this patient group is not always sufficiently considered or treated in an effective manner.

Aim: The recommendations presented in this paper address possible improvements in pain management in hemophilia patients and particularities that have to be taken into account in this patient group.

Method: The manifold aspects of pain management in hemophilia patients were discussed within the framework of an expert meeting. Based on the available literature and the experts' clinical experience, the participants developed a set of recommendations presented in this paper.

Results: Pain management in patients with hemophilia is often insufficient, a fact that not only influences the patients' quality of life but also implies the risk of difficult to manage chronic pain. Both the prevalent polypharmacy (due to comorbidities) as well as the underlying disease itself present special challenges to pain therapy in this patient group. The present review and recommendations are intended to support medical professionals in recognising the risks of pain chronicity, applying basic principles of multimodal pain therapy, including the options of psychological intervention and modalities of physical medicine in therapy concepts, and reaching a comprehensive understanding of the range of analgesic options available.

Keywords: Factor concentrate; Hemophilia; Joint bleeds; Pain chronification; Pain therapy.

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Conflict of interest statement

W. Stromer, R. Crevenna, J. Donnerer, C. Feistritzer, S. Hemberger, R. Likar, F. Sevelda, K. Thom, B. Wagner and W. Streif declare that they have no competing interests. I. Pabinger received fees for occasional lectures and advisory board meetings from Bayer, Biotest, CSL Behring, Novo Nordisk, Pfizer, Roche, Sobi. C. Ay received personal fees from Shire/Takeda, Bayer, CSL Behring, Octapharma, Roche and Sobi for lectures and/or participation in advisory boards.

References

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