Evaluating the feasibility of delivering a pain management programme for adults living with sickle cell disease

Rebecca McLoughlin; Jenna Love; Jared G Smith; Whitney Scott; Tim Noblet

doi:10.1177/20494637231202744

Evaluating the feasibility of delivering a pain management programme for adults living with sickle cell disease

Br J Pain. 2024 Jun;18(3):257-273. doi: 10.1177/20494637231202744. Epub 2023 Sep 21.

Authors

Rebecca McLoughlin¹, Jenna Love¹, Jared G Smith^{2

3}, Whitney Scott^{4

5}, Tim Noblet⁶

Affiliations

¹ Red Cell Pain Management & Psychology Service, St George's University Hospitals NHS Foundation Trust, London, UK.
² Population Health Research Institute, St George's University of London, London, UK.
³ Clinical Research Unit, South West London & St George's Mental Health Trust, Springfield University Hospital, London, UK.
⁴ Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁵ INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.
⁶ Physiotherapy Department, St George's University Hospitals NHS Foundation Trust, London, UK.

PMID: 38751559
PMCID: PMC11092933 (available on 2025-06-01)
DOI: 10.1177/20494637231202744

Abstract

Background: Pain is the prominent feature of sickle cell disease (SCD) and negatively affects quality of life. Delivery of pain management programmes (PMPs) has been suggested in clinical guidelines for pain management in SCD; however, further evidence of the feasibility and effectiveness of PMPs in this population is needed. This study explored the feasibility of delivering a sickle cell pain management programme (SCPMP) for adults within a haemoglobinopathies service.

Methods: A single arm, repeated-measures observational design was used to determine feasibility of delivering the SCPMP at one study site. Primary feasibility outcomes were recruitment, completion of treatment and outcome measures, satisfaction, credibility and acceptability to participants. Secondary feasibility outcomes were treatment outcomes and processes, frequency of vaso-occlusive crisis (VOC) and healthcare utilisation.

Results: Four of five feasibility criteria were met. Annual recruitment of eight participants to a SCPMP was not achieved. Twenty-nine people began a SCPMP during the study period. Twenty-five (86.2%) participants attended ≥5/8 sessions and 21(84%) programme completers provided all end of programme questionnaires. Mean scores of >7 on ten-point scales were seen across satisfaction and credibility questions. At least moderate (Hedges g >0.5) effect sizes were seen in pre-post SCPMP measures of pain interference, anxiety, depression, self-efficacy, pain-related worry and acceptance. A small (Hedges g 0.4) effect size was seen in HRQoL. Following SCPMP attendance, mean frequency of self-reported VOC and hospital admissions reduced.

Conclusions: This study suggests that, given an adequate source of referrals, a SCPMP is feasible to deliver and appears acceptable and credible to participants. Exploration of influences on recruitment, such as barriers to group interventions, would be illuminating, prior to investigating feasibility of an adequately powered randomised-controlled trial.

Keywords: chronic pain; pain management programme; persistent pain; sickle cell; sickle cell disease.