• Michelle Witkop, Maria Santaella, Cynthia D Nichols, Angela Y Lambing, Kimberly Baumann, Randall G Curtis, Christi Humphrey, Thomas J Humphries, Jennifer Newman, Nancy Durben, Rhonda Fritz, Kimberly Mauer, Constance B Thibodeaux, Emily Wheat, and Tyler Buckner.
• National Hemophilia Foundation, New York, New York, USA.
• Pain Med. 2022 Feb 1; 23 (2): 269-279.

ObjectivesPain is a known complication in persons with hemophilia (PWH) as a result of muscle and joint bleeding. Little is known regarding national Hemophilia Treatment Center (HTC) practice patterns related to pain management. The aim of this study was to: 1) Describe pain management practice patterns of HTC providers, 2) Identify gaps and areas of alignment with the CDC pain guidelines, and 3) Address educational opportunities for pain management. This survey is the first extensive description of multidisciplinary practice patterns of pain management for PWH.MethodsThis descriptive study involved physicians, nurse practitioners, nurses, physical therapists, and social workers from federally funded Hemophilia Treatment Centers (HTC) eligible to complete an online survey exploring pain management practice patterns within the CDC pain guidelines.ResultsResults of this survey shed light on areas of strength and cohesiveness between HTC providers, including the following: dedication to effective pain management, utilization of non-pharmacological pain options, trial of non-opioid medications first before opioids, maintaining follow-up with patients after opioid prescription initiation, recognizing and utilizing clinically important findings before prescribing opioids, and counseling their patients regarding potential risk factors.ConclusionsThere remain opportunities to incorporate into clinical practice consistent use of tools such as formal screening questionnaires, opioid use agreements, written measurable goals, ongoing prescription monitoring, and written plans for discontinuation of opioid therapy. These results provide opportunities for improvement in education of HTC team members thus optimizing pain management in persons with bleeding disorders.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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