Exploring Pain and Opioid Misuse Among Patients With Sickle Cell Anemia: Associations With Health Literacy and Pain Catastrophizing.

Abstract

Purpose: This study aimed to investigate pain characteristics, opioid misuse prevalence, and the relationship between healthliteracy and pain catastrophising in patients with Sickle Cell Disease (SCD).

Design: This was a cross-sectional study.

Methods: Data were collected from patients with SCD in Oman. Validated tools were used to assess pain (Brief Pain Inventory), healthliteracy (HLS-Q12), opioid misuse (Current Opioid Misuse Measure [COMM]), and pain catastrophising (Pain Catastrophising Scale).

Results: The study included 169 patients with SCD, with an average age of 34.4 (SD = 12.9) years, of whom 51.5% werefemale. A total of 79.3% of the participants reported experiencing pain, with an average total pain score of 3.8 (SD = 2.6).Additionally, 74% of the patients were identified as being at risk of opioid misuse. The risk of opioid misuse was positivelyassociated with pain catastrophising (r = 0.302, p < 0.001) and negatively associated with health literacy (r = -0.220, p = 0.005). Pain severity and interference are also linked to the risk of opioid misuse. Sociodemographic factors, such as age, sex, and education, showed no significant association with the risk of opioid misuse.

Conclusions: Patients with SCD face high rates of chronic pain and considerable risk of opioid misuse. Psychological factors, particularly pain catastrophising and lower healthliteracy, were strongly associated with misuse risk, while sociodemographic factors had less impact.

Clinical implications: These findings highlight the need for targeted interventions addressing psychological support and health literacy to reduce opioidmisuse in SCD patients. Healthcare providers should integrate pain management strategies with educational programs to enhancehealth literacy and mitigate the psychological burden of pain.