Pain Frequency and Health Care Utilization Patterns in Women with Sickle Cell Disease Experiencing Menstruation-Associated Pain Crises

Catherine Segbefia; Jillian Campbell; Immacolata Tartaglione; Eugenia Vicky Asare; Biree Andemariam; William Zempsky; Raffaella Colombatti; Gifty Dankwah Boatemaa; Donna Boruchov; Sudha Rao; Connie M Piccone; Ashya Smith; Haikel Haile; Esther Kim; Samuel Wilson; Fatimah Farooq; Rebekah Urbonya; Angela Rivers; Deepa Manwani; Jiaxiang Gai; Fredericka Sey; Baba Inusa; Charles Antwi-Boasiako; Crawford Strunk; Andrew D Campbell

doi:10.1089/jwh.2023.0023

Pain Frequency and Health Care Utilization Patterns in Women with Sickle Cell Disease Experiencing Menstruation-Associated Pain Crises

J Womens Health (Larchmt). 2023 Dec;32(12):1284-1291. doi: 10.1089/jwh.2023.0023. Epub 2023 Nov 23.

Authors

Catherine Segbefia^{1

2}, Jillian Campbell³, Immacolata Tartaglione⁴, Eugenia Vicky Asare⁵, Biree Andemariam⁶, William Zempsky⁷, Raffaella Colombatti⁸, Gifty Dankwah Boatemaa⁹, Donna Boruchov⁷, Sudha Rao², Connie M Piccone¹⁰, Ashya Smith¹¹, Haikel Haile¹¹, Esther Kim¹¹, Samuel Wilson¹¹, Fatimah Farooq¹¹, Rebekah Urbonya¹¹, Angela Rivers¹², Deepa Manwani¹³, Jiaxiang Gai¹⁴, Fredericka Sey¹⁵, Baba Inusa¹⁶, Charles Antwi-Boasiako^{9

17}, Crawford Strunk¹⁸, Andrew D Campbell^{3

11

19}

Affiliations

¹ Department of Child Health, University of Ghana Medical School, Accra, Ghana.
² Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
³ Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA.
⁴ Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy.
⁵ Department of Hematology, Korle-Bu Teaching Hospital, Accra, Ghana.
⁶ Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, University of Connecticut, Farmington, Connecticut, USA.
⁷ Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
⁸ Department of Women's and Child Health, Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova, Padova, Italy.
⁹ Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
¹⁰ Department of Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA.
¹¹ Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
¹² Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
¹³ Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA.
¹⁴ Division of Biostatistics and Study Methodology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
¹⁵ Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana.
¹⁶ Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, College of Nursing, London, United Kingdom.
¹⁷ College of Health Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
¹⁸ Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Foundation, Cleveland, OH, USA.
¹⁹ Division of Hematology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

PMID: 38011013
PMCID: PMC10712351 (available on 2024-12-01)
DOI: 10.1089/jwh.2023.0023

Abstract

Background: Pain crises in sickle cell disease (SCD) lead to high rates of health care utilization. Historically, women have reported higher pain burdens than men, with recent studies showing a temporal association between pain crisis and menstruation. However, health care utilization patterns of SCD women with menstruation-associated pain crises have not been reported. We studied the frequency, severity, and health care utilization of menstruation-associated pain crises in SCD women. Materials and Methods: A multinational, cross-sectional cohort study of the SCD phenotype was executed using a validated questionnaire and medical chart review from the Consortium for the Advancement of Sickle Cell Research (CASiRe) cohort. Total number of pain crises, emergency room/day hospital visits, and hospitalizations were collected from a subcohort of 178 SCD women within the past 6 months and previous year. Results: Thirty-nine percent of women reported menstruation-associated pain crises in their lifetime. These women were significantly more likely to be hospitalized compared with those who did not (mean 1.70 vs. 0.67, p = 0.0005). Women reporting menstruation-associated pain crises in the past 6 months also experienced increased hospitalizations compared with those who did not (mean 1.71 vs. 0.75, p = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. Conclusions: Nearly 40% of SCD women have menstruation-associated pain crises. Menstruation-associated pain crises are associated with high pain burden and increased rates of hospitalization. Strategies are needed to address health care disparities within gynecologic care in SCD.

Keywords: health care utilization; hospitalizations; menstruation; pain crises; sickle cell disease.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Anemia, Sickle Cell* / complications
Anemia, Sickle Cell* / epidemiology
Anemia, Sickle Cell* / therapy
Cross-Sectional Studies
Dysmenorrhea / complications
Female
Healthcare Disparities
Humans
Male
Menstruation*
Patient Acceptance of Health Care

Grants and funding

T37 MD001425/MD/NIMHD NIH HHS/United States