154 - Patient and Guardian Views on Acupuncture for Pain Crises in Sickle Cell Disease

Vaso-occlusive pain crises (VOC) are the most frequent manifestation and the primary cause of morbidity for patients with sickle cell disease (SCD). Few advancements have been made in the management of acute VOC, with opioids and non-steroidal anti-inflammatory drugs remaining the mainstay of treatment. Acupuncture may be a potential adjuvant therapy for VOC, but there is limited data on the perspectives of patients with SCD and their guardians on this treatment modality.

Objective:

The primary objective was to identify patient and caregiver perspectives on the use of acupuncture for pain management during a pain crisis. A secondary objective was to elicit patient reported outcomes.

Design/Methods:

A cross-sectional survey was conducted at an outpatient hematology clinic at a single tertiary academic medical center. Patients with SCD (age 8-17y) and guardians of patients with SCD (age 6 mo-17y) were approached to complete a 10-item survey. The survey was administered orally by study staff. We reported survey results as frequencies and percentages.

Results:

We enrolled 23 patients and 27 guardians. Response rates of patients and guardians approached were 82% (23/28) and 73% (27/37), respectively. Among patients, 82% had experienced VOC and one patient had previously received acupuncture. 48% of patients reported willingness to receive acupuncture, among whom most (91%) were amenable to its receipt during VOC. The most common cited reason for disinterest was discomfort with needles. Rates of acceptability were similar among patients < 13 years (40%) and >13 years (54%). Among guardians, 78% reported their child had experienced VOC. 62% of guardians were amenable to their child receiving acupuncture, among whom 88% were amenable to its receipt during VOC. A majority of patients (70%) and guardians (70%) were interested in learning more about acupuncture. 50% (6/12) of patients who expressed uncertainty or disinterest in acupuncture requested additional education. Outcomes important to patients and guardians for a novel therapy during pain crises included less time spent in the hospital, a reduction in pain medicine required, and improved mood and energy.

Conclusion(s):

Our results lend support to institutional efforts to offer integrative health therapies, including acupuncture, to patients with SCD experiencing VOC. Furthermore, this study found patient and guardian interest in education on acupuncture, even among those not currently amenable to its use, emphasizing the need for patient and family education. Further research is needed to investigate the efficacy of acupuncture during pain crises.