Opioid Prescribing in the Emergency Department for Sickle Cell Disease (DOPED-SCD)

Differential Opioid Prescribing in the Emergency Department for Patients With Sickle Cell Disease: a Vignette-based International Randomised Trial.

This study consists of a clinical vignette presented to emergency physicians asking them what they would prescribe to a patient with acute abdominal pain.

Study Overview

• Status: Completed
• Conditions: Sickle Cell Disease; Emergency Medicine; Pain Management; Discrimination, Racial
• Intervention / Treatment: Behavioral: opioid prescription

• Study Type: Observational
• Enrollment (Actual): 1063

Contacts and Locations

Study Locations

• France
  • Occitanie
    • Nîmes, Occitanie, France, 30900
      • CHU de Nîmes
• United Kingdom
  • Manchester
    • Manchester, Manchester, United Kingdom, M139WL
      • Manchester University NHS FT

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Population will consist in emergency medicine resident and physician, speaking French or English, in European countries.

The population will be recruited with the use of professional networks and social medias

Description

Inclusion Criteria:

• Being a emergency physician

Exclusion Criteria:

• Working outside of Europe.

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Non-black man; the case will present a non black man	Behavioral: opioid prescription; The intervention consisted of a randomized questionnaire presenting a clinical case of a patient suffering from severe abdominal pain. The control case was "As an emergency physician in an adult emergency department, you are presented with the following patient: The patient is a 39-year-old non-smoking male/female with a history of Meniere's disease and an allergy to Bactrim. He/she presents with abdominal pain that began abruptly 2 hours ago and has persisted despite taking NEFOPAM 45 minutes ago. This is his first episode. His/her vital signs are blood pressure 140/66, heart rate 91, pulse ox 97%, temperature 36.8°C. He/she rates his/her pain as 8/10 without any analgesic position. On clinical examination he/she presents with localized epigastric tenderness. The rest of the abdomen is soft, painless and depressed. There are hydro-aeriform noises. No diarrhea or vomiting. The rest of the clinical examination showed no abnormalities.". In the intervention case, patient had history of S
Black man; the case will present a non black man	Behavioral: opioid prescription; The intervention consisted of a randomized questionnaire presenting a clinical case of a patient suffering from severe abdominal pain. The control case was "As an emergency physician in an adult emergency department, you are presented with the following patient: The patient is a 39-year-old non-smoking male/female with a history of Meniere's disease and an allergy to Bactrim. He/she presents with abdominal pain that began abruptly 2 hours ago and has persisted despite taking NEFOPAM 45 minutes ago. This is his first episode. His/her vital signs are blood pressure 140/66, heart rate 91, pulse ox 97%, temperature 36.8°C. He/she rates his/her pain as 8/10 without any analgesic position. On clinical examination he/she presents with localized epigastric tenderness. The rest of the abdomen is soft, painless and depressed. There are hydro-aeriform noises. No diarrhea or vomiting. The rest of the clinical examination showed no abnormalities.". In the intervention case, patient had history of S
non-black woman; the case will present a non black woman	Behavioral: opioid prescription; The intervention consisted of a randomized questionnaire presenting a clinical case of a patient suffering from severe abdominal pain. The control case was "As an emergency physician in an adult emergency department, you are presented with the following patient: The patient is a 39-year-old non-smoking male/female with a history of Meniere's disease and an allergy to Bactrim. He/she presents with abdominal pain that began abruptly 2 hours ago and has persisted despite taking NEFOPAM 45 minutes ago. This is his first episode. His/her vital signs are blood pressure 140/66, heart rate 91, pulse ox 97%, temperature 36.8°C. He/she rates his/her pain as 8/10 without any analgesic position. On clinical examination he/she presents with localized epigastric tenderness. The rest of the abdomen is soft, painless and depressed. There are hydro-aeriform noises. No diarrhea or vomiting. The rest of the clinical examination showed no abnormalities.". In the intervention case, patient had history of S
black woman; the case will present a black woman	Behavioral: opioid prescription; The intervention consisted of a randomized questionnaire presenting a clinical case of a patient suffering from severe abdominal pain. The control case was "As an emergency physician in an adult emergency department, you are presented with the following patient: The patient is a 39-year-old non-smoking male/female with a history of Meniere's disease and an allergy to Bactrim. He/she presents with abdominal pain that began abruptly 2 hours ago and has persisted despite taking NEFOPAM 45 minutes ago. This is his first episode. His/her vital signs are blood pressure 140/66, heart rate 91, pulse ox 97%, temperature 36.8°C. He/she rates his/her pain as 8/10 without any analgesic position. On clinical examination he/she presents with localized epigastric tenderness. The rest of the abdomen is soft, painless and depressed. There are hydro-aeriform noises. No diarrhea or vomiting. The rest of the clinical examination showed no abnormalities.". In the intervention case, patient had history of S

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Morphine prescription	The proportion of patient for which physician would have prescribed morphine	through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Analgesic prescription between groups	To compare analgesic prescription between groups	through study completion, an average of 1 year
factors associated with differences in management between groups	identify factors associated with differences in management (urgency level, morphine prescription and computed tomography scan ordering)	through study completion, an average of 1 year
Differences according to patient and practitioner gender	analyze the difference in morphine treatment prescribed according to patient and practitioner gender	through study completion, an average of 1 year

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nīmes

Publications and helpful links

General Publications

• Coisy F, Simon A, Occelli C, Dupriez F, Ageron FX, N'Diaye L, Feral-Pierssens AL, Yates G, Bobbia X. Does a history of sickle cell disease affect the prescription of morphine? An international, randomised study based on clinical vignettes conducted among emergency physicians. BMJ Open. 2025 Dec 24;15(12):e108836. doi: 10.1136/bmjopen-2025-108836.

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2025
• Primary Completion (Actual): March 19, 2025
• Study Completion (Actual): March 19, 2025

Study Registration Dates

• First Submitted: February 10, 2025
• First Submitted That Met QC Criteria: February 14, 2025
• First Posted (Actual): February 19, 2025

Study Record Updates

• Last Update Posted (Actual): January 23, 2026
• Last Update Submitted That Met QC Criteria: January 21, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Genetic Diseases, Inborn; Neurobehavioral Manifestations; Hematologic Diseases; Anemia, Hemolytic, Congenital; Anemia, Hemolytic; Anemia; Hemoglobinopathies; Perceptual Disorders; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Hemic and Lymphatic Diseases; Social Behavior; Prejudice; Social Discrimination; Anemia, Sickle Cell; Agnosia; Racism; Physiological Effects of Drugs; Peripheral Nervous System Agents; Central Nervous System Depressants; Sensory System Agents; Analgesics; Narcotics; Analgesics, Opioid
• Other Study ID Numbers: 25.02.01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No