As one of the most commonly inherited disorders, sickle cell disease can warrant the need for specialized treatment plans. Especially when it comes to pain, different factors can arise and impact the daily lives of those with sickle cell disease. Therefore, there is a need for individualized care plans when treating acute pain crises from sickle cell disease to improve quality of life outcomes, such as hospital stay duration and healthcare costs.
Most patients with sickle cell disease present to the emergency department when experiencing an acute pain episode. These pain episodes can lead to complications and increase the risk of hospital admission or readmission.
No single pain management plan applies to all patients. Healthcare providers should seek to provide patient-centered care when managing patients with sickle cell disease. Without effective, consistent analgesic usage, patients with sickle cell disease are more likely to experience an increased need for inpatient care. In many cases, hospitals may not have uniform guidelines for pain management in an inpatient setting, so individualized care plans could prove highly beneficial.
One retrospective analysis evaluated the use of individualized care plans and their effect on hospital costs, readmissions, pain severity, duration of hospital stays, and other outcomes. Over two years, these outcomes were measured.
Ultimately, it was found that individualized care plans significantly decreased the duration of hospitalizations by around one day, with no worsened pain severity scores. In addition, the seven-day readmission rate decreased by 34%, and the use of intravenous hydromorphone significantly decreased by 25%. Over the length of the study, approximately $1,398,827 were saved due to the quality initiative plan [1].
Other studies have found similar results. For example, one study evaluated the use of a specialized care plan in the emergency department for improved care of vaso-occlusive crises from sickle cell disease. The care plan was made into order sets and included a lab collection process, pain medication regimens, opioid refill policies, follow-up protocols, and criteria for hospital admission. This individualized sickle cell disease plan helped drop the thirty-day readmission rate from 40% to 3%. The average length of stay was also reduced [2].
So, what are the chief benefits of individualized care plans for sickle cell disease? They’re sustainable and can help reduce both the physical and financial burden of acute pain crises from this unpredictable disease.
Sources:
[1] Welch-Coltrane, J. L., Wachnik, A. A., Adams, M. C. B., Avants, C. R., Blumstein, H. A., Brooks, A. K., Farland, A. M., Johnson, J. B., Pariyadath, M., Summers, E. C., & Hurley, R. W. (2021). Implementation of individualized pain care plans decreases length of stay and hospital admission rates for high utilizing adults with sickle cell disease. Pain Medicine. https://doi.org/10.1093/pm/pnab092
[2] Ahmed, B., Day, T., Hirner, C., Trendle, M., Heidt, J., & Singh, S. (2018). Role of effective care plans in reducing admissions for sickle cell patients. Journal of Clinical Oncology, 36(30_suppl), 156. https://doi.org/10.1200/jco.2018.36.30_suppl.156
