HOME MANAGEMENT OF SICKLE CELL-RELATED PAIN IN CHILDREN AND ADOLESCENTS - NATURAL-HISTORY AND IMPACT ON SCHOOL ATTENDANCE

Some children and adolescents with sickle cell disease experience freq uent painful episodes. To gain information about the natural history o f the pain and its impact on sleep and school attendance, we developed a home-based diary system. Eighteen children and adolescents complete d 4756 diary days, with an average compliance of 75%. Pain was reporte d on 30% of days and was managed at home nine-tenths of the time. Girl s reported more days with pain than did boys, and age was positively c orrelated with the length of the painful episodes. The pain affected s chool 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 p ain 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.