Wally R. Smith
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View article: A therapy-driven approach to designing personalized pain care in sickle cell disease
A therapy-driven approach to designing personalized pain care in sickle cell disease Open
Background: Chronic pain in Sickle Cell Disease (SCD) is not one-size-fits-all. It stems from a mix of biological, psychological, and social factors, yet treatment strategies remain largely reactive and generalized. Traditional efforts to …
View article: Evolving annual community health worker time allocation to maximize sickle cell disease medical home efficiency
Evolving annual community health worker time allocation to maximize sickle cell disease medical home efficiency Open
Background: Medical center-based Community Health Workers, also known as Patient Navigators (PNs), play a vital but varied role in comprehensive care within adult sickle cell disease (SCD) medical homes. Depending on the need of the moment…
View article: Behavioral health and biophysical complexity as predictors of healthcare utilization in adults with sickle cell disease
Behavioral health and biophysical complexity as predictors of healthcare utilization in adults with sickle cell disease Open
Background: Identifying predictors of high healthcare utilization in adults with Sickle Cell Disease (SCD) remains a clinical and operational priority. This study examined whether behavioral health (Bh) and Biophysical complexity (Bio) sco…
View article: Comparative effectiveness of emergency department versus pain infusion clinic management for acute pain in adults with sickle cell disease: Implications for cost and timeliness of care
Comparative effectiveness of emergency department versus pain infusion clinic management for acute pain in adults with sickle cell disease: Implications for cost and timeliness of care Open
Background: Acute pain is the most common reason for healthcare utilization among adults living with Sickle Cell Disease (SCD). While Emergency Departments (EDs) remain the default care setting for many SCD patients in pain, ED use is ofte…
View article: Improvements in health-related quality of life in patients with transfusion-dependent β-thalassemia after exagamglogene autotemcel
Improvements in health-related quality of life in patients with transfusion-dependent β-thalassemia after exagamglogene autotemcel Open
Transfusion-dependent β-thalassemia (TDT) can have negative impacts on a patient’s health-related quality of life (HRQoL). Exagamglogene autotemcel (exa-cel) is a one-time, ex vivo CRISPR-Cas9 gene–edited cell therapy for TDT shown in a ph…
View article: Improvements in health-related quality of life in patients with severe sickle cell disease after exagamglogene autotemcel
Improvements in health-related quality of life in patients with severe sickle cell disease after exagamglogene autotemcel Open
Severe sickle cell disease (SCD), an inherited blood disorder characterized by recurrent vaso-occlusive crises (VOCs), significantly impairs health-related quality of life (HRQoL). Exagamglogene autotemcel (exa-cel), a one-time, ex vivo CR…
View article: Physicians' Opinions of COVID-19 Ambulatory Care Constraints
Physicians' Opinions of COVID-19 Ambulatory Care Constraints Open
CORONAVIRUS DISEASE-2019 (COVID-19) has spread rapidly across the United States and has led to dramatic alterations to health care delivery within a short period (Cutler et al., 2020). Outpatient clinical volumes have declined as a consequ…
View article: Protocol for a Multisite Trial Evaluating Digital Cognitive Behavioral Therapy With and Without Peer Support Among Adolescents and Young Adults With Chronic Sickle Cell Pain
Protocol for a Multisite Trial Evaluating Digital Cognitive Behavioral Therapy With and Without Peer Support Among Adolescents and Young Adults With Chronic Sickle Cell Pain Open
Background The transition from adolescence to adulthood in individuals with sickle cell disease (SCD) is a time of high risk for both acute and chronic pain, contributing to poor physical and mental health outcomes. Digital cognitive behav…
View article: Altered Resting-State Functional Connectivity in Sickle Cell Disease: Insights Into Pain Sensitivity and Cerebral Hemodynamics
Altered Resting-State Functional Connectivity in Sickle Cell Disease: Insights Into Pain Sensitivity and Cerebral Hemodynamics Open
Background We previously reported both heightened pain sensitivity and impaired fluid cognition in Sickle Cell Disease (SCD) patients (1). The two may be linked, potentially via altered brain connectivity. Understanding specific disruption…
View article: The Impact of Distance to Care on Healthcare Utilization in Sickle Cell Disease
The Impact of Distance to Care on Healthcare Utilization in Sickle Cell Disease Open
Background Access to specialized care is critical for individuals with Sickle Cell Disease (SCD), yet geographical barriers may limit healthcare utilization. This study examines the relationship between distance to care and healthcare serv…
View article: Preliminary observations on cerebral blood flow and pain sensitivity in adults with SCD
Preliminary observations on cerebral blood flow and pain sensitivity in adults with SCD Open
Objectives SCD is characterized by chronic anemia, cerebral ischemia, and significant pain, including acute and chronic manifestations. Prior studies have highlighted a link between silent cerebral ischemia, elevated cerebral blood flow (C…
View article: Behavioral and transcriptional effects of age in HbSS-BERK humanized SCD mice
Behavioral and transcriptional effects of age in HbSS-BERK humanized SCD mice Open
Objectives SCD is associated with morbidity, mortality, and severe pain that is well modeled in humanized Berkeley SCD (HbSS) mice. Here, we conducted a comprehensive study to evaluate the effects of age on the development of the HbSS hype…
View article: Altered cerebral blood flow and functional connectivity in sickle cell disease
Altered cerebral blood flow and functional connectivity in sickle cell disease Open
Background Adults with sickle cell disease (SCD) often experience cognitive deficits and chronic pain, but the cerebral mechanisms underlying these symptoms remain unclear. Elevated cerebral blood flow (CBF) is a compensatory response to a…
View article: Mathematical modeling of SCD: a literature review
Mathematical modeling of SCD: a literature review Open
SCD is a family of genetic blood disorders that affects over 20 million people worldwide. SCD complications include pain, anemia, and early death. The hallmark cause of medical visits for people with SCD is pain, initially in the form of a…
View article: Preliminary validity of a daily functional status pain assessment tool
Preliminary validity of a daily functional status pain assessment tool Open
Objectives Readiness for discharge for a SCD vaso-occlusive crisis is dictated by factors far beyond pain control, including physical function/activity. We therefore designed and tested a functional status-based pain assessment questionnai…
View article: Association of Unmet Social Needs With Disease‐Related Outcomes in Pediatric Patients With Sickle Cell Disease
Association of Unmet Social Needs With Disease‐Related Outcomes in Pediatric Patients With Sickle Cell Disease Open
Background Social determinants of health (SDoH) are socioeconomic factors that influence health and well‐being, though when unmet can greatly contribute to health disparities. Individuals with sickle cell disease (SCD) are at increased ris…
View article: Hematopoietic Cell Transplant compared with Standard Care in Adolescents and Young Adults with Sickle Cell Disease.
Hematopoietic Cell Transplant compared with Standard Care in Adolescents and Young Adults with Sickle Cell Disease. Open
Disease-modifying therapies are standard of care (SOC) for sickle cell disease (SCD), but hematopoietic cell transplantation (HCT) has curative potential. We compared outcomes prospectively through 2-years after biologic assignment to a Do…
View article: Comparative Analysis of Whole-Brain and Regional Cerebral Blood Flow, Pain Expression, Pain Sensitivity, and Cognitive Function in Adults with Sickle Cell Disease Versus Healthy Controls
Comparative Analysis of Whole-Brain and Regional Cerebral Blood Flow, Pain Expression, Pain Sensitivity, and Cognitive Function in Adults with Sickle Cell Disease Versus Healthy Controls Open
Background Sickle Cell Disease (SCD) is well-known to cause anemia, acute and chronic pain, organ dysfunction including silent cerebral ischemia, and subtle cognitive impairment. Treatment and prevention for all of these is poor to non-exi…
View article: Enhanced Pain Sensitivity in Adult Sickle Cell Disease Patients: Potential Mediating Factors
Enhanced Pain Sensitivity in Adult Sickle Cell Disease Patients: Potential Mediating Factors Open
Background Sickle Cell Disease (SCD) is a genetic disorder characterized by chronic anemia, recurrent painful vaso-occlusive crises, and multiple systemic complications. Among these, silent cerebral ischemia (SCI) is a prevalent yet often …
View article: Sickle Pain-Related Impact (SPiRIt): A Prospective Study of Impact of Chronic Pain in Sickle Cell Disease
Sickle Pain-Related Impact (SPiRIt): A Prospective Study of Impact of Chronic Pain in Sickle Cell Disease Open
Objective: (1) To compare the pain phenotype and pain-related patient-reported outcomes (PROs) between sub-phenotypes of chronic pain (CP), i.e., high-impact chronic pain (HICP) and mild-moderate chronic pain (MMCP) in adolescents and youn…
View article: Comparing Emergency Department and Infusion Clinic Outcomes Among Individuals with Sickle Cell Disease Seeking Care for Vaso-Occlusive Crises
Comparing Emergency Department and Infusion Clinic Outcomes Among Individuals with Sickle Cell Disease Seeking Care for Vaso-Occlusive Crises Open
Background: Sickle Cell disease (SCD) is a rare genetic disorder of the blood that results in red blood cells sickling and occluding blood vessels. Vaso-occlusive crises (VOCs) are the most common clinical manifestation of SCD which are ch…
View article: Hematopoietic cell transplant compared with standard care in adolescents and young adults with sickle cell disease
Hematopoietic cell transplant compared with standard care in adolescents and young adults with sickle cell disease Open
Disease-modifying therapies are standard of care (SOC) for sickle cell disease (SCD), but hematopoietic cell transplantation (HCT) has curative potential. We compared outcomes prospectively through 2 years after biologic assignment to a do…
View article: Validity of Functional Status and Pain Assessment Scale in Hospitalized Adult SCD Patients
Validity of Functional Status and Pain Assessment Scale in Hospitalized Adult SCD Patients Open
Presentation Date: 6/9/2024 Presentation Start Time: 3:00:00 PM Background Despite the prevalence of hospitalization in Sickle Cell Disease (SCD) due to pain and Vaso-Occlusive Crisis (VOC), there are no validated measures to evaluate eith…
View article: Adult SCD Patient Prior Authorization Outcomes by Pharmacy Reimbursement Specialist
Adult SCD Patient Prior Authorization Outcomes by Pharmacy Reimbursement Specialist Open
Presentation Date: 6/9/2024 Presentation Start Time: 1:30:00 PM Background Sickle cell disease (SCD) represents a complex and often debilitating hematologic disorder characterized by chronic pain episodes and significant healthcare utiliza…
View article: Empowering Adolescent and Young Adults with SCD by Enhancing Career Choices and Support
Empowering Adolescent and Young Adults with SCD by Enhancing Career Choices and Support Open
Presentation Date: 6/9/2024 Presentation Start Time: 3:30:00 PM Background Over 40% of Americans live with at least one chronic illness. Their illness poses unique barriers in social determinants of health, including employment. Initiative…
View article: Investigating home‐based opioid use among youth with sickle cell disease using ecological momentary assessment
Investigating home‐based opioid use among youth with sickle cell disease using ecological momentary assessment Open
Background 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 characterize…
View article: High-impact chronic pain in sickle cell disease: insights from the Pain in Sickle Cell Epidemiology Study (PiSCES)
High-impact chronic pain in sickle cell disease: insights from the Pain in Sickle Cell Epidemiology Study (PiSCES) Open
The US National Pain Strategy recommends identifying individuals with chronic pain (CP) who experience substantial restriction in work, social, or self-care activities as having high-impact chronic pain (HICP). High-impact chronic pain has…
View article: Gender Differences in the Support of Medical Marijuana Use Among Primary Care Providers
Gender Differences in the Support of Medical Marijuana Use Among Primary Care Providers Open
Background: Despite the increased use and availability of cannabis, little is known about provider perceptions and practices regarding cannabis. The present study examined support for use of medical marijuana/tetrahydrocannabinol (THC) amo…
View article: What interval of daily pain assessment is required to reliably diagnose chronic pain in SCD? The Pain in Sickle Cell Epidemiology Study
What interval of daily pain assessment is required to reliably diagnose chronic pain in SCD? The Pain in Sickle Cell Epidemiology Study Open
Objectives Chronic pain in SCD has been defined as pain on most days over 6 months. In the landmark Pain in Sickle Cell Epidemiology Study, 60% of patients submitted <5 of the expected 6 months of pain diaries. Identifying chronic SCD p…