Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Feb 1;23(2):269-279.
doi: 10.1093/pm/pnab196.

Understanding the Pain Management Landscape Within the US Bleeding Disorder Community: A Multi-Center Survey

Michelle Witkop  1 , Maria Santaella  1 , Cynthia D Nichols  2 , Angela Y Lambing  3 , Kimberly Baumann  4 , Randall G Curtis  5 , Christi Humphrey  6 , Thomas J Humphries  7 , Jennifer Newman  8 , Nancy Durben  9 , Rhonda Fritz  10 , Kimberly Mauer  9 , Constance B Thibodeaux  11 , Emily Wheat  12 , Tyler Buckner  13
Affiliations
Multicenter Study

Understanding the Pain Management Landscape Within the US Bleeding Disorder Community: A Multi-Center Survey

Michelle Witkop et al. Pain Med. .

Abstract

Objectives: Pain is a known complication in persons with hemophilia (PWH) as a result of muscle and joint bleeding. Little is known regarding national Hemophilia Treatment Center (HTC) practice patterns related to pain management. The aim of this study was to: 1) Describe pain management practice patterns of HTC providers, 2) Identify gaps and areas of alignment with the CDC pain guidelines, and 3) Address educational opportunities for pain management. This survey is the first extensive description of multidisciplinary practice patterns of pain management for PWH.

Methods: This descriptive study involved physicians, nurse practitioners, nurses, physical therapists, and social workers from federally funded Hemophilia Treatment Centers (HTC) eligible to complete an online survey exploring pain management practice patterns within the CDC pain guidelines.

Results: Results of this survey shed light on areas of strength and cohesiveness between HTC providers, including the following: dedication to effective pain management, utilization of non-pharmacological pain options, trial of non-opioid medications first before opioids, maintaining follow-up with patients after opioid prescription initiation, recognizing and utilizing clinically important findings before prescribing opioids, and counseling their patients regarding potential risk factors.

Conclusions: There remain opportunities to incorporate into clinical practice consistent use of tools such as formal screening questionnaires, opioid use agreements, written measurable goals, ongoing prescription monitoring, and written plans for discontinuation of opioid therapy. These results provide opportunities for improvement in education of HTC team members thus optimizing pain management in persons with bleeding disorders.

Keywords: Bleeding Disorders; CDC Pain Guidelines; Chronic Pain; Hemophilia; Hemophilia Treatment Centers; Pain.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Ratings for importance of specific clinical findings when considering opioid prescribing.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. The Diagnosis of Hemophilia. CDC Centers for Disease Controls. Available at: https://www.cdc.gov/ncbddd/hemophilia/diagnosis.html (accessed May 2020).
    1. Soucie JM, Miller CH, Dupervil B, Le B, Buckner TW. Occurrence rates of haemophilia among males in the United States based on surveillance conducted in specialized haemophilia treatment centers. Haemophilia 2020;26(3):487–93. - PMC - PubMed
    1. Auerswald G, Dolan G, Duffy A, et al. Pain and pain management in haemophilia. Blood Coagul Fibrin 2016;27(8):845–54. - PMC - PubMed
    1. Bolton-Maggs PH, Pasi KJ. Haemophilia A and B. Lancet 2003;361(9371):1801–9. - PubMed
    1. Gringeri A, Ewenstein B, Reininger A. The burden of bleeding in haemophilia: Is one bleed too many? Haemophilia 2014;20(4):459–63. - PubMed

Publication types

MeSH terms

Substances