Targeted Education Program Improves Hydroxyurea Use in Sickle Cell Anemia
After a sickle cell anemia (SCA) complication resulting in an emergency department (ED) visit, participation in a clinic that provides education on starting hydroxyurea increases the use of this agent, according to an observational cohort study. The educational clinic, dubbed the Quick-Start Hydroxyurea Initiation Project (Q-SHIP), included a hematologist-led discussion on hydroxyurea, a video of patients discussing hydroxyurea, and a direct offer to start hydroxyurea.
Over 64 weeks, 112 patients presented to the ED with an SCA complication, with 59% (n=66) participating in a Q-SHIP session a median of 6 days after their ED visit or hospital discharge. Overall, 55% of Q-SHIP participants (n=36) started hydroxyurea, with 83% (n=30) still on hydroxyurea after a median follow-up of 49 weeks. Laboratory markers of hydroxyurea adherence were found to be significantly increased from baseline. Comparing Q-SHIP participants to nonparticipants, 12 weeks after their ED visit, participants were more likely to have started hydroxyurea than nonparticipants (53% vs 20%, P=.0004) and to be taking hydroxyurea at last follow-up (50% vs 20%, P=.001). Two years after the implementation of Q-SHIP initiative, the investigators found that the overall proportion of eligible patients on hydroxyurea presenting to their ED increased from 56% to 80% (P=.0069).
Read more here.
Reference
Pecker LH, Kappa S, Greenfest A, Darbari DS, Nickel RS. Targeted hydroxyurea education after an emergency department visit increases hydroxyurea use in children with sickle cell anemia. J Pediatr. 2018 Oct;201:221-228.e16. doi: 10.1016/j.jpeds.2018.05.019.
