Q44-46: Pain

Question 44: Has vaso-occlusive pain occurred requiring hospitalization or treatment? (treatment that is in a hospital or clinic setting since the date of last report)

Vaso-occlusive pain, sometimes called a pain crisis, is a common painful complication of sickle cell disease in adolescents and adults. Recurrent episodes may cause irreversible organ damage.

Report Yes in the following scenarios:

• The recipient experienced vaso-occlusive pain requiring hospitalization or treatment (i.e., ER admission, day hospital, inpatient admission, etc.) in the current reporting period.
• The recipient experienced vaso-occlusive pain requiring hospitalization or treatment prior to HCT or in a prior reporting period, resolved, and developed in the current reporting period.
  

Report No in any of the following scenarios:

• The recipient did not experience vaso-occlusive pain the current reporting period
• Vaso-occlusive pain occurred in the reporting period, but hospitalization or treatment was not required
• The recipient was hospitalized or received treatment in a prior reporting period for vaso-occlusive pain and continued hospitalization or treatment into the current reporting period
  

If no information is available to determine if the recipient required hospitalization or treatment for vaso-occlusive pain since the date of last report, select Unknown.

Question 45: Has there been any new onset of chronic pain?

Indicate Yes or No if the recipient experienced a new onset of chronic pain in the current reporting. Chronic pain is defined as pain that is present a majority of days per month, lasting for ≥ 6 months with one more of the following:

• Without contributory SCD complications (acute vaso-occlusive pain, acute chest syndrome, leg ulcers, avascular necrosis; or,
• Mixed pain type in which chronic pain is occurring at site(s) (arms, back, chest, or abdominal pain) but unrelated to any sites associated with SCD complications
  

The progress notes should clearly document if chronic pain is present or absent. If is not clear, based on the documentation available, whether chronic pain is present or absent, report Unknown.

*Chronic Pain Prior to Infusion
For recipients with chronic pain prior to infusion, chronic pain may be reported in the Day 100 reporting period. However, for recipients who did not have chronic pain prior to infusion, the earliest reporting period in which chronic pain should be reported is the 6-month reporting period.

Question 46: Were opioids prescribed for the treatment of pain?

Opioids are typically listed in the medical administration record (MAR) and/or in the medication list documented on the progress note within the medical record. Examples of opioid treatment may include Hydrocodone, Methadone, Hydromorphone (Dilaudid), etc.
Indicate if the recipient was prescribed opioids for treatment of either vaso-occlusive or chronic pain during this reporting period. If opioids were prescribed for treatment of pain, report Yes. If opioids were not prescribed for treatment of pain or if no information is available to determine if opioids were prescribed for treatment of pain, report No.

Section Updates:

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