Mercado Stephanie Harris
Stephanie Harris Mercado practices in the University of California San Francisco's Community Cancer Institute, Sickle Cell Disease clinic in Fresno, Calif. The author has disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2023 Mar 1;36(3):20-23. doi: 10.1097/01.JAA.0000920956.33631.26.
Sickle cell disease (SCD), one of the most common inherited diseases, is associated with lifetime morbidity and reduced life expectancy. In the United States, SCD primarily affects Black patients and, to a lesser degree, those of Hispanic descent. These populations are known to have healthcare disparities related to lower socioeconomic status, limited access to healthcare, and racial bias. The quality-adjusted life expectancy of patients with SCD is less than 35 years, because of progressive complications of the disease. The most common complication is severe episodic pain related to vaso-occlusive ischemic events. Despite guidelines, pain management often is delayed as patients struggle with resistance from clinicians based on concerns over opioid use or abuse, overdose, or drug-seeking behavior. Effective pain management can be accomplished with collaboration between clinicians and patients, a documented outpatient pain management plan, and when necessary, an ED clinical pain pathway for acute SCD pain management.
镰状细胞病（SCD）是最常见的遗传性疾病之一，与终生发病和预期寿命缩短有关。在美国，SCD主要影响黑人患者，在较小程度上影响西班牙裔患者。已知这些人群存在与社会经济地位较低、医疗保健机会有限和种族偏见相关的医疗保健差异。由于该疾病的进行性并发症，SCD患者的质量调整预期寿命不到35岁。最常见的并发症是与血管闭塞性缺血事件相关的严重发作性疼痛。尽管有相关指南，但由于患者因临床医生对阿片类药物使用或滥用、过量用药或寻求药物行为的担忧而面临阻力，疼痛管理往往会延迟。有效的疼痛管理可以通过临床医生与患者之间的合作、记录在案的门诊疼痛管理计划以及必要时用于急性SCD疼痛管理的急诊临床疼痛路径来实现。
