Sickle Cell Disease Clinical Trial
Official title:
PHEDRE Trial Protocol - Observational Study of the Prevalence of Problematic Use of Equimolar Mixture of Oxygen and Nitrous Oxide (EMONO) and Analgesics in the French Sickle-cell Disease Population
The use of analgesics can lead to cases of drug abuse and dependence. It can also cause
pseudo-addiction in patients suffering from pain. What is the actual situation in patients
suffering from severe sickle-cell disease, exposed to acute pain during vaso-occlusive
crises? Evaluation of the use of analgesics, on the basis of Diagnostic and Statistical
Manual of Mental Disorders criteria for substance abuse and dependence, makes it possible to
differentiate the symptoms occurring only in a context of pain, in the aim of managing the
pain, and thus describing pseudo-addiction, from symptoms also occurring when there is no
pain, and more in favour of true addiction. Currently there is no data available in France on
this problem, and no studies have been carried out in children or adolescents with
sickle-cell disease. The purpose of the study is to evaluate the prevalence of problematic
use of equimolar mixture of oxygen and nitrous oxide and other analgesic drugs in a
population of subjects with severe sickle-cell disease in France.
PHEDRE (Pharmacodépendance Et DREpanocytose-drug dependence and sickle-cell disease) is an
observational, descriptive and transversal study. Patients under the age of 26 with
sickle-cell disease are included in the study by the doctors looking after them in
sickle-cell disease centres. The patients are then contacted by a trained researcher for a
telephone interview, including an evaluation of the Diagnostic and Statistical Manual of
Mental Disorders criteria for abuse and dependence to equimolar mixture of oxygen and nitrous
oxide and for each of the analgesic drugs taken by the patient. The data are also completed
using the subject's medical record.
This study will make it possible to provide an initial quantitative and qualitative
evaluation of problematic use of equimolar mixture of oxygen and nitrous oxide and analgesic
drugs in the sickle-cell disease population. The results will be used firstly to provide
additional data essential for monitoring the risk of overdose, abuse, dependence and misuse
of these products, and to begin awareness-raising and to provide information for health care
professionals, in order to significantly improve the management of sickle-cell
disease-related pain.
This is a national multicentric observational study
•Clinical assessment
After he includes a patient, the medical practitioner complete a clinical assessment which
contains all information about patient's family and personal history, history of the SCD and
treatment already received for SCD. The clinical assessment is kept in the Reference Centre
or Special Centre for Children and Adults (RSCCA). Therefore, the trained researcher will
schedule a visit to the RSCCA to retrieve the clinical assessments of all patients included
in this RSCCA and enter the data in the electronic case report form (e-CRF).
- Telephone interview
Telephone interview is carried out with a trained researcher from Nantes CEIP-A. When Nantes
CEIP-A receipts the inclusion form and written consent, the trained researcher schedules a
telephone interview with the patient. The interview is suited to the child's, adolescent's or
young adult's age, maturity and comprehension skills. The following parameters are evaluated
during the telephone semi-structured interview for EMONO, and for other analgesic drugs,
during pain episodes and outside pain episodes.
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