ASH: Few Sickle Cell ED Visits Adhere to Guidelines for Opioid Pain Meds

TUESDAY, Dec. 9, 2025 (HealthDay News) — For patients with acute sickle cell disease (SCD) pain presenting to the emergency department (ED), guideline adherence for delivery of opioid pain medications is inadequate, according to a study presented at the annual meeting of the American Society of Hematology, held from Dec. 6 to 9 in Orlando, Florida.

Ibrahim Gwarzo, M.D., Dr.P.H., M.B.B.S., from Nemours Children”s Health in Delaware, and colleagues examined guideline adherence of opioid pain medication administration for patients with SCD treated for acute pain across multiple EDs. All ED visits with a primary International Classification of Diseases diagnosis code indicating SCD pain crisis, where at least one opioid pain medication was administered, were included.

The study included 394,725 ED visits from 40,977 unique patients at 228 sites. The researchers found that 32.5 percent of the visits were guideline-adherent for the first opioid dose within 60 minutes of ED arrival. Guideline adherence was 9.0 percent for the second dose for the 302,738 visits with multiple doses. Guideline adherence for the first dose did not change on stratification by route of administration, while orally administered opioids had higher guideline adherence for the second dose (24.3 percent compared with 7.7 percent for parenteral doses). Guideline adherence for the first dose was higher for patients with SCD aged 19 years and younger versus those older than 19 years in the univariate analysis (52.0 versus 29.6 percent); the relationship persisted for the second dose.

“We want to call attention to the fact that there is huge room for improvement across the board, particularly in general emergency departments that primarily attend to adults,” Gwarzho said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

Abstract

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