Jacobs-McFarlane Charleen, Liu Angela, McCrary Brittany, McCuskee Sarah, Wexler Mikayla Gordon, Stidham Elizabeth, Zhang Bin, Glassberg Jeffrey, Curtis Susanna
Mount Sinai Hospital-Nursing Department, New York, NY.
Department of Hematology, Icahn School of Medicine at Mount Sinai, New York, NY.
Pain Manag Nurs. 2025 May 29. doi: 10.1016/j.pmn.2025.04.012.
Sickle cell disease (SCD) is an inherited genetic disorder affecting an estimated 100,000 people in the United States. The hallmark of SCD is acute and chronic pain, which leads to increased healthcare utilization. Pain in SCD is treated with full opioid agonists with variable effectiveness. There is growing evidence supporting buprenorphine in adults with SCD for pain.
The objective of this study was to describe the health outcomes of buprenorphine use in adults with SCD.
This study was a single-center, retrospective cohort study of all individuals with SCD and chronic pain treated with buprenorphine between November 2020 and January 2024. Descriptive statistics and paired t-tests were used to compare health outcomes before and after treatment.
Thirteen inductions were completed, six using telemedicine, two with a diagnosis of opioid use disorder, one individual (7.7%) failed induction and did not continue buprenorphine. Median duration of follow-up was 103 days (range 21-1,497 days). Buprenorphine use was associated with lower annualized rates of emergency department visits (7.2 vs 5.9, -1.3, p < .001), hospital admissions (8.5 vs 5.6, -2.9, p < .001), and treatment center visits (3.0 vs 2.2, -0.9, p < .001), and lower rates of home opioid use (189.3 vs 35.6 morphine milligram equivalent, -153.7, p < .001).
Buprenorphine induction was successful using telemedicine and for those with opioid use disorder. Buprenorphine was associated with lower opioid use and healthcare utilization in patients with SCD and chronic pain.
镰状细胞病（SCD）是一种遗传性疾病，在美国估计有10万人受其影响。SCD的标志是急性和慢性疼痛，这导致医疗保健利用率增加。SCD患者的疼痛采用全阿片类激动剂治疗，效果各异。越来越多的证据支持在患有SCD的成人中使用丁丙诺啡治疗疼痛。
本研究的目的是描述丁丙诺啡在患有SCD的成人中的健康结局。
本研究是一项单中心回顾性队列研究，研究对象为2020年11月至2024年1月期间所有接受丁丙诺啡治疗的SCD和慢性疼痛患者。使用描述性统计和配对t检验比较治疗前后的健康结局。
完成了13次诱导，6次使用远程医疗，2次诊断为阿片类药物使用障碍，1名个体（7.7%）诱导失败，未继续使用丁丙诺啡。中位随访时间为103天（范围21-1497天）。使用丁丙诺啡与较低的急诊科就诊年化率（7.2对5.9，-1.3，p<.001）、住院率（8.5对5.6，-2.9，p<.001）和治疗中心就诊率（3.0对2.2，-0.9，p<.001）相关，家庭阿片类药物使用率也较低（189.3对35.6吗啡毫克当量，-153.7，p<.001）。
使用远程医疗对丁丙诺啡进行诱导对患有阿片类药物使用障碍的患者是成功的。丁丙诺啡与SCD和慢性疼痛患者较低的阿片类药物使用和医疗保健利用率相关。
