Identifying Social-Behavioral Health Needs of Adults with Sickle Cell Disease in the Emergency Department.

Published

Journal Article

INTRODUCTION:Sickle cell disease (SCD) is a complex illness with many social-behavioral co-morbidities. The aim of this project was to describe unmet social-behavioral health needs for adults with SCD who presented to the emergency department for treatment of vaso-occlusive episodes (VOEs). METHODS:A descriptive study using 1:1 interviews during an ED visit for a VOE was conducted; a brief social behavioral health screening interview guide was used. A convenience sample of adults with SCD treated in the emergency department for a VOE were eligible for inclusion. RESULTS:We conducted 147 interviews over 14 months. Patients reported transportation and/or scheduling difficulties with clinic appointments in one third of the interviews. Four major themes emerged: clinic appointment barriers, medication barriers, other care barriers, and social-behavioral issues. A majority of patients (53%) reported being brought to the emergency department by a family member at their current visit. Patients cited having insurance coverage issues in more than one quarter (27%) of the interviews. Difficulties in obtaining prescriptions were cited as a result of a financial copay (17%), transportation (11%), and pharmacy (9%) issues. Almost one third of patients (29%) reported feeling depressed, and 20% reported feeling anxious. DISCUSSION:Many patients with SCD who are treated in the emergency department have social or behavioral health risk factors. Emergency departments have an opportunity to screen and refer patients for follow-up. Future research should investigate referral outcomes and their effect on ED and hospital use.

Full Text

Duke Authors

Cited Authors

  • Smith, SK; Johnston, J; Rutherford, C; Hollowell, R; Tanabe, P

Published Date

  • September 2017

Published In

Volume / Issue

  • 43 / 5

Start / End Page

  • 444 - 450

PubMed ID

  • 28527641

Pubmed Central ID

  • 28527641

Electronic International Standard Serial Number (EISSN)

  • 1527-2966

International Standard Serial Number (ISSN)

  • 0099-1767

Digital Object Identifier (DOI)

  • 10.1016/j.jen.2017.04.009

Language

  • eng