Dr C. Patrick Carroll on Barriers to Accessing Nonpharmacologic Treatments to SDC-Related Pain

There is not a lot of evidence on how well nonpharmacologic treatments work to treat sickle cell disease—related pain, and it can be difficult to get people access to these treatments, said C. Patrick Carroll, MD, director of psychiatric services, Sickle Cell Center for Adults, associate professor of psychiatry, Johns Hopkins Medicine.

Transcript

How can or are nonpharmacologic treatments being used in patients with sickle cell disease—related pain?

Yeah, the simplest, most honest, answer is we don't really know. There's not a lot of research about, first of all the effectiveness of them, and second, how often people get to access them.

With respect to the things that are probably had the best evidence based, things like cognitive therapy, behavioral therapy, and so forth, we don't know how well they work, particularly for chronic pain in sickle cell disease. And there are a lot of health system barriers to engaging people in them. It's difficult to find providers who are skilled in those particular subsets of patients and delivering the therapy to them. It's even frankly, difficult sometimes to get people funded to see me. I'm a psychiatrist by training and having people seen for a pain evaluation by me often doesn't get funded.

So, there are a number of barriers to accessing some of these things that are outside of the traditional medical system that make it hard to do. My suspicion is that people wanted a lot but don't actually wind up getting access to it much.