阿片类药物是治疗急性镰状细胞病 (SCD) 疼痛的常见且必要的治疗方法。然而，阿片类药物具有众所周知的不良副作用，包括潜在的痛觉过敏和伤害性疼痛。我们使用生态瞬时评估 (EMA) 数据来描述患有 SCD 的青少年的阿片类药物使用情况，并调查了家庭阿片类药物使用、疼痛和一系列生物心理社会因素之间的关系。 88 名患有 SCD 的青少年（8-17 岁）完成了评估家庭阿片类药物使用、疼痛和相关因素的 EMA。分析包括描述性和多级逻辑回归，以预测日常家庭阿片类药物的使用。青少年平均 EMA 为 3.64 周。大约 35% 的样本 (n = 31) 在 EMA 期间服用阿片类药物，并且仅在 24% 报告的疼痛日使用它们。与不服用阿片类药物的青少年相比，服用阿片类药物的青少年的疼痛天数百分比（t = -2.67，p < .05）和平均疼痛严重程度评分（t = -2.30，p < .05）更高。多级逻辑回归分析表明，每日疼痛严重程度较高（比值比 [OR] = 1.02，p < .01）、年龄较大（OR = 1.324，p < .01）和低积极情绪（OR = 0.91，p <.01）。 01）均与阿片类药物使用的可能性增加有关。患有 SCD 的青少年根据每日自我报告，适当服用阿片类药物以应对疼痛。除了日常疼痛的严重程度之外，年龄和积极情绪的日常变化也与家庭阿片类药物的使用有关。这表明增强积极情感的行为干预可能会促进患有 SCD 的青少年减少阿片类药物的使用。© 2024 作者。儿科血液

Opioids are a common and essential treatment for acute sickle cell disease (SCD) pain. However, opioids carry well-known adverse side effects, including potential development of hyperalgesia and nociplastic pain. We characterized opioid use in youth with SCD using ecological momentary assessment (EMA) data, and investigated the relationships between home-based opioid use, pain, and a range of biopsychosocial factors.Eighty-eight youth with SCD (aged 8-17 years) completed EMAs assessing home-based opioid use, pain, and related factors. Analyses consisted of descriptive and multilevel logistic regression to predict daily home opioid use.Youth averaged 3.64 weeks of EMAs. Approximately 35% of the sample (n = 31) took an opioid during the EMA period, and used them on only 24% of reported pain days. Youth who took opioids reported a higher percentage of pain days (t = -2.67, p < .05) and mean pain severity scores (t = -2.30, p < .05) than youth who did not take opioids. Multilevel logistic regression analyses indicated that high daily pain severity (odds ratio [OR] = 1.02, p < .01), older age (OR = 1.324, p < .01), and low positive affect (OR = 0.91, p < .01) were each related to an increased likelihood of opioid use.Youth with SCD take opioids appropriately in response to their pain, based on daily self-report. Beyond daily pain severity, age, and daily variation in positive affect were related to home-based opioid use. This suggests that behavioral interventions that enhance positive affect may promote reduced opioid use among youth with SCD.© 2024 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.