Kudos to Nancy Crego, assistant professor, for the submission of her NIH R03 application entitled "DAT- Exploring Opioid Use, Misuse and Prescribing Patterns in Children and Adolescents with Sickle Cell Disease." This proposal requests funds for a 2 year period with a proposed start date of July 1, 2020.

Sickle Cell Disease (SCD), is a complex genetic blood disorder affecting 100,000 predominantly African-Americans, in which painful, vaso-occlusive episodes (VOE) cause severe recurrent acute pain that is difficult to manage, unpredictable and can lead to life threatening complications. SCD pain episodes often start in early childhood requiring at home treatment with opioids, increasing the risk for opioid related adverse events, misuse and substance use disorder later in life. Life-long patterns of unmanageable SCD pain and healthcare overuse often begin in adolescence and are greatly influenced by parental disease management. Management of acute pain episodes begins at home with adolescents learning self-management skills and developing self-efficacy in partnership with social supports including parents and healthcare providers (HCPs). Self-efficacy plays an important role in reduction of pain severity. Adolescents must start to develop self-efficacy, pain coping behaviors and skills such as using non-opioid alternatives in childhood, in order to effectively self-manage pain, reduce misuse and long-term reliance on opioids.

The goals of this study are to understand parent and adolescent non-pharmacologic and pharmacologic (non-opioid and opioid) home management of acute SCD pain, opioid treatment decision-making, opioid misuse, and HCP opioid home management and instructional practices. The expected outcome is an in-depth understanding of at home pain management practices, particularly opioid use by adolescents with SCD, their parent/caregiver and HCP that will be used to develop culturally and developmentally informed home pain management interventions (including opioid administration decision support tools) and implementation methods that improve self-efficacy, improve pain management and reduced opioid use by adolescents diagnosed with SCD