The Relationship of Opioid Analgesia to Quality of Life in an Adult Sickle Cell
Population
Soheir S. Adam, MD1, Jude C. Jonassaint, RN1, Charles R. Jonassaint, MA2, Marilyn J.
Telen, MD1, Laura M. De Castro, MD1
1
Department of Medicine, Duke University Medical Center, Durham, North Carolina,
27710
2
Department of Psychiatry, Duke University, Durham, North Carolina, 27710
Correspondence and Reprint Requests:
Soheir Adam, MD
Duke University Medical Center
Box 3939
Durham, NC 27710
TEL: 919 684-6464
FAX: 919 681-6174
Email: soheir.adam@duke.edu
Context: Pain is a limiting factor in the daily life activities of sickle cell disease patients.
Although opioid analgesics are widely used, to date there have been no studies on the
relationship of daily opioid use to quality of life measures in this population.
Objective: To determine the relationship of opioid analgesia to quality of life in adults
with sickle cell.
Design: Data were collected by patient interviews and review of medical records. The
Medical Outcome Study 36-item Short Form (SF36) was used to determine quality of
life.
Setting: Duke Comprehensive Sickle Cell Center.
Patients: 185 out-patients with various genotypes of sickle cell disease.
Main Outcome Measure: Quality of life as measured by the SF36.
Results: Quality of life outcomes were not lower in individuals with the classically more
severe homozygous SS when compared to the heterozygous SC. SF36 scores were
significantly lower in individuals who were on opioids alone or on opioids and
hydroxyurea concurrently, as compared to those who were either on no medications or on
hydroxyurea alone. Disease severity scores were not significantly different between
groups. When controlling for hydroxyurea use, the negative association between opioid
use and SF36 scores remained unchanged.
Conclusions: Sickle cell patients using opioids daily had significantly poorer quality of
life than those who were not on opioids. Disease severity scores were not significantly
different in the two patient groups. Prospective studies are needed to define the
relationship of opioid use to quality of life in sickle cell disease and opioid interaction
with hydroxyurea.