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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 7 of 7 Research Studies Displayed
Hodges JR, Phillips SM, Norell S
Intentional and unintentional nonadherence to hydroxyurea among people with sickle cell disease: a qualitative study.
The objective of this study was to examine barriers to patients' adherence to hydroxyurea-use regimens by using the intentional and unintentional medication nonadherence framework. Individuals with sickle cell disease (SCD) aged 15 to 49.9 years who were participants in the Sickle Cell Disease Implementation Consortium (SCDIC) Needs Assessment were interviewed. Findings showed that participants with SCD more frequently endorsed adherence barriers that fell into the unintentional nonadherence type vs intentional nonadherence type. Results from this study will help SCD health care providers to understand patient choices and decisions as being either unintentional or intentional, to guide tailored clinical discussions regarding hydroxyurea therapy, and to develop specific, more nuanced interventions to address nonadherence factors.
Citation: Hodges JR, Phillips SM, Norell S . Intentional and unintentional nonadherence to hydroxyurea among people with sickle cell disease: a qualitative study. Blood Adv 2020 Sep 22;4(18):4463-73. doi: 10.1182/bloodadvances.2020001701..
Keywords: Sickle Cell Disease, Medication, Patient Adherence/Compliance
Alberts NM, Badawy SM, Hodges J
Development of the incharge health mobile app to improve adherence to hydroxyurea in patients with sickle cell disease: user-centered design approach.
This study looked at how use of a newly developed mobile app called InCharge Health can help sickle cell disease (SCD) patients adhere to their prescribed medication use of hydroxyurea. Four phases were used to develop the mobile app with substantial input from users and by mapping the Health Belief Model (HBM) as the framework that guided the choice for its components. More than half of the patients reported potentially low health literacy. Preferred patient app features included 7 key components: medication reminders and tracker, disease education, communication, personalization, motivation, support during pain episodes, and social support. This information was translated into features within the app.
Citation: Alberts NM, Badawy SM, Hodges J . Development of the incharge health mobile app to improve adherence to hydroxyurea in patients with sickle cell disease: user-centered design approach. JMIR Mhealth Uhealth 2020 May 8;8(5):e14884. doi: 10.2196/14884..
Keywords: Sickle Cell Disease, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Medication
Kayle M, Valle J, Paulukonis S
Impact of Medicaid expansion on access and healthcare among individuals with sickle cell disease.
The purpose of this study was to examine whether Medicaid expansion in California, increased Medicaid enrollment, increased hydroxyurea prescriptions filled, and decreased acute healthcare utilization in sickle cell disease (SCD). Findings showed that Medicaid expansion did not appear to have improved enrollment or acute healthcare utilization among individuals with SCD in California. Recommendations included future studies exploring whether individuals with SCD transitioned to other insurance plans or became uninsured post-expansion, the underlying reasons for low hydroxyurea utilization, and the lack of effect on hospital admissions despite a modest effect on emergency department visits.
AHRQ-funded; HS023011; HS025297.
Citation: Kayle M, Valle J, Paulukonis S . Impact of Medicaid expansion on access and healthcare among individuals with sickle cell disease. Pediatr Blood Cancer 2020 May;67(5):e28152. doi: 10.1002/pbc.28152..
Keywords: Sickle Cell Disease, Medicaid, Access to Care, Healthcare Utilization, Medication, Hospitalization, Health Insurance
Crego N, Douglas C, Bonnabeau E
Sickle-cell disease co-management, health care utilization, and hydroxyurea use.
Sickle-cell disease (SCD) causes significant morbidity, premature mortality, and high disease burden, resulting in frequent health care use. Comanagement may improve utilization and patient adherence with treatments such as Hydroxyurea. The purpose of this study was to describe acute-care utilization in Medicaid-enrolled patients with SCD, patient factors associated with comanagement, and adherence to Hydroxyurea. The investigators concluded that comanagement was a factor in predicting HUadherence, but further studies are needed to identify the frequency and components of comanagement needed to increase adherence and reduce acute care utilization.
Citation: Crego N, Douglas C, Bonnabeau E . Sickle-cell disease co-management, health care utilization, and hydroxyurea use. J Am Board Fam Med 2020 Jan-Feb;33(1):91-105. doi: 10.3122/jabfm.2020.01.190143..
Keywords: Sickle Cell Disease, Children/Adolescents, Medication, Healthcare Utilization, Patient Adherence/Compliance
Badawy SM, Thompson AA, Liem RI
Beliefs about hydroxyurea in youth with sickle cell disease.
The objectives of this study were to assess beliefs about hydroxyurea using the Beliefs about Medicines Questionnaire (BMQ), and to examine the relationship of patients' beliefs to their hydroxyurea adherence and health-related quality of life (HRQOL). The investigators found that beliefs about hydroxyurea correlated with HRQOL scores and adherence levels. The authors suggest that addressing patients' concerns about hydroxyurea and medications overall as well as routine assessment of adherence and beliefs could help to overcome adherence barriers.
Citation: Badawy SM, Thompson AA, Liem RI . Beliefs about hydroxyurea in youth with sickle cell disease. Hematol Oncol Stem Cell Ther 2018 Sep;11(3):142-48. doi: 10.1016/j.hemonc.2018.01.001..
Keywords: Children/Adolescents, Medication, Patient Adherence/Compliance, Quality of Life, Sickle Cell Disease
Reeves SL, Tribble AC, Madden B
Antibiotic prophylaxis for children with sickle cell anemia.
This study calculated the proportion of children with sickle cell anemia (SCA) who received at least 300 days of antibiotic prophylaxis against invasive pneumococcal disease and identified predictors of receipt. Children with SCA between 3 months and 5 years old were identified by the presence of three or more Medicaid claims with a diagnosis of SCA within a calendar year in six states. Receipt of antibiotics was identified through claims for filled prescriptions. The authors conclude that antibiotic prophylaxis rates are low among children with SCA; more healthcare encounters may offer opportunities for increased intervention. Potential predictors were identified as age, sex, year, state, and health services usage.
Citation: Reeves SL, Tribble AC, Madden B . Antibiotic prophylaxis for children with sickle cell anemia. Pediatrics 2018 Mar;141(3). doi: 10.1542/peds.2017-2182..
Keywords: Sickle Cell Disease, Children/Adolescents, Antibiotics, Prevention, Pneumonia, Medication
Tanabe P, Silva S, Bosworth HB
A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD).
Limited evidence guides opioid dosing strategies for acute Sickle Cell (SCD) pain. In this randomized control study, the investigators compared two National Heart, Lung and Blood Institute (NHBLI) recommended opioid dosing strategies (weight-based vs. patient-specific) for emergency department (ED) treatment of acute vaso-occlusive episodes (VOE).
Citation: Tanabe P, Silva S, Bosworth HB . A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD). Am J Hematol 2018 Feb;93(2):159-68. doi: 10.1002/ajh.24948..
Keywords: Medication, Opioids, Pain, Sickle Cell Disease