Home management of sickle cell-related pain in children and adolescents: natural history and impact on school attendance

Abstract

Diary days, with an average compliance of 75%. Pain was reported on 30% of days and was managed at home nine-tenths of the time. Girls reported more days with pain than did boys, and age was positively correlated with the length of the painful episodes. The pain affected school attendance and sleep. Patients were absent from school on 21% of 3186 school days, with half of the absenteeisms on days with reported pain. Of the pain-associated absenteeisms, two-thirds occurred when pain was managed at home, and one-third when patients were hospitalized. The average consecutive number of school days missed was 2.7. These findings have implications for developmentally critical activities. ∗Corresponding author: Barbara Shapiro, M.D., Children's Hospital of Philadelphia, Division of General Pediatrics, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, USA. (Received 29 October 1993; revision received 13 July 1994; accepted 20 July 1994.) © Lippincott-Raven Publishers....