(344) - Psychosocial predictors of home opioid use in youth with sickle cell disease: a pilot study

Abstract

Sickle cell disease (SCD) can result in both acute pain crises and recurrent pain. Youth with SCD are often prescribed opioid medications to take as needed (PRN) to manage pain in the home setting. The frequency with which youth take PRN opioids varies, and these medications may have negative side effects. Few studies have investigated what factors may predict the frequency of opioid use in youth with SCD in the home setting. The current study aims to evaluate psychological factors (depression, pain catastrophizing, problem-focused coping efficacy) as predictors of opioid use frequency in youth with SCD. Youth ages 10–18 years with SCD (n = 23) completed a baseline survey in clinic assessing psychosocial factors (PROMIS Depression, Pain Catastrophizing Scale-Child, Pain Beliefs Questionnaire) and completed an online pain and medication diary for 14 days. On average, youth reported pain 33.7% (range 0–100%) days of the 14-day period and took opioid medications 11.26% (range 0–66.67%) of study days. Average daily pain intensity and opioid use frequency were highly correlated (r = .64). Controlling for average pain intensity over the diary period, lower problem-focused coping efficacy at baseline significantly predicted more frequent opioid use (β = −.37, p = .025). Greater baseline depressive symptoms marginally predicted more frequent opioid use (β = .34, P = .05). Baseline pain catastrophizing may reach significance as a predictor of opioid use frequency in a larger sample (β = .27, P = .15). These results suggest that depressive symptoms and perceived inability to cope with pain may be associated with greater opioid use in the home setting, above and beyond pain intensity in youth with SCD. Future research should evaluate psychosocial interventions targeting children's efficacy for coping with pain and depressive symptoms to reduce PRN opioid use and potential negative side effects in youth with SCD.