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A systematic review of barriers and interventions to improve appropriate use of therapies for sickle cell disease.

Publication ,  Journal Article
Haywood, C; Beach, MC; Lanzkron, S; Strouse, JJ; Wilson, R; Park, H; Witkop, C; Bass, EB; Segal, JB
Published in: J Natl Med Assoc
October 2009

Clinical experts have expressed concern about underutilization of sickle cell disease (SCD) therapies, including hydroxyurea, prophylactic antibiotics, iron chelation, bone marrow transplantation, pain management during vaso-occlusive crisis, and receipt of routine ambulatory health care. We synthesized studies that identified barriers to and interventions to improve appropriate use of these therapies. Of the 48 studies included in our review, 35 identified therapeutic barriers or facilitators, and 13 evaluated interventions to improve use of therapies. Consistently identified barriers to appropriate pain management were negative provider attitudes and lack of provider knowledge. Four of 9 pain management interventions improved direct measures of pain management quality, while 5 improved indirect measures. One intervention improved receipt of routine ambulatory care. We concluded that interventions to improve pain management in SCD can be effective and should address providers' negative attitudes and knowledge and that more intervention studies are needed to improve receipt of recommended SCD therapies.

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Published In

J Natl Med Assoc

DOI

ISSN

0027-9684

Publication Date

October 2009

Volume

101

Issue

10

Start / End Page

1022 / 1033

Location

United States

Related Subject Headings

  • Public Health
  • Practice Patterns, Physicians'
  • Pain Management
  • Humans
  • Health Services Needs and Demand
  • Health Services Accessibility
  • Health Knowledge, Attitudes, Practice
  • Drug Utilization
  • Disease Progression
  • Attitude of Health Personnel
 

Citation

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Haywood, C., Beach, M. C., Lanzkron, S., Strouse, J. J., Wilson, R., Park, H., … Segal, J. B. (2009). A systematic review of barriers and interventions to improve appropriate use of therapies for sickle cell disease. J Natl Med Assoc, 101(10), 1022–1033. https://doi.org/10.1016/s0027-9684(15)31069-5
Haywood, Carlton, Mary Catherine Beach, Sophie Lanzkron, John J. Strouse, Renee Wilson, Haeseong Park, Catherine Witkop, Eric B. Bass, and Jodi B. Segal. “A systematic review of barriers and interventions to improve appropriate use of therapies for sickle cell disease.J Natl Med Assoc 101, no. 10 (October 2009): 1022–33. https://doi.org/10.1016/s0027-9684(15)31069-5.
Haywood C, Beach MC, Lanzkron S, Strouse JJ, Wilson R, Park H, et al. A systematic review of barriers and interventions to improve appropriate use of therapies for sickle cell disease. J Natl Med Assoc. 2009 Oct;101(10):1022–33.
Haywood, Carlton, et al. “A systematic review of barriers and interventions to improve appropriate use of therapies for sickle cell disease.J Natl Med Assoc, vol. 101, no. 10, Oct. 2009, pp. 1022–33. Pubmed, doi:10.1016/s0027-9684(15)31069-5.
Haywood C, Beach MC, Lanzkron S, Strouse JJ, Wilson R, Park H, Witkop C, Bass EB, Segal JB. A systematic review of barriers and interventions to improve appropriate use of therapies for sickle cell disease. J Natl Med Assoc. 2009 Oct;101(10):1022–1033.
Journal cover image

Published In

J Natl Med Assoc

DOI

ISSN

0027-9684

Publication Date

October 2009

Volume

101

Issue

10

Start / End Page

1022 / 1033

Location

United States

Related Subject Headings

  • Public Health
  • Practice Patterns, Physicians'
  • Pain Management
  • Humans
  • Health Services Needs and Demand
  • Health Services Accessibility
  • Health Knowledge, Attitudes, Practice
  • Drug Utilization
  • Disease Progression
  • Attitude of Health Personnel