Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use.

Publication ,  Journal Article
Crego, N; Douglas, C; Bonnabeau, E; Earls, M; Eason, K; Merwin, E; Rains, G; Tanabe, P; Shah, N
Published in: J Am Board Fam Med
2020

BACKGROUND: 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. METHODS: Data from 2790 patients diagnosed with SCD, age 1 to 65+ years, enrolled at least 1 month in North Carolina Medicaid between March 2016 and February 2017, were analyzed. Outpatient visits were categorized as primary care, hematologist, and nonhematologist specialist. Nurse practitioners or physician assistants with unidentified specialty type or family practice were categorized separately. Comanagement was defined as a minimum of 1 primary care and 1 hematologist visit/patient during the study period. RESULTS: There were notable age-related differences in utilization of health care services. Only 34.82% of the sample was comanaged. Comanagement was higher in the 1-to-9-year-old (44.88%) and 10-to-17-year-old groups (39.22%) versus the 31-to-45-year-old (30.26%) and 65+-year-old (18.75%) age groups. Age had the greatest influence (AUC = 0.599) on whether or not a patient was comanaged. Only a third of the sample (32.24%) had at least 1 Hydroxyurea (HU) prescription. Age was the most predictive factor of good HUadherence (AUC = 0.6503). Prediction by comanagement was minimal with an AUC = 0.5615. CONCLUSION: 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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Board Fam Med

DOI

EISSN

1558-7118

Publication Date

2020

Volume

33

Issue

1

Start / End Page

91 / 105

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • North Carolina
  • Middle Aged
  • Medication Adherence
  • Medicaid
  • Infant
  • Hydroxyurea
  • Humans
  • General & Internal Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Crego, N., Douglas, C., Bonnabeau, E., Earls, M., Eason, K., Merwin, E., … Shah, N. (2020). Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use. J Am Board Fam Med, 33(1), 91–105. https://doi.org/10.3122/jabfm.2020.01.190143
Crego, Nancy, Christian Douglas, Emily Bonnabeau, Marian Earls, Kern Eason, Elizabeth Merwin, Gary Rains, Paula Tanabe, and Nirmish Shah. “Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use.J Am Board Fam Med 33, no. 1 (2020): 91–105. https://doi.org/10.3122/jabfm.2020.01.190143.
Crego N, Douglas C, Bonnabeau E, Earls M, Eason K, Merwin E, et al. Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use. J Am Board Fam Med. 2020;33(1):91–105.
Crego, Nancy, et al. “Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use.J Am Board Fam Med, vol. 33, no. 1, 2020, pp. 91–105. Pubmed, doi:10.3122/jabfm.2020.01.190143.
Crego N, Douglas C, Bonnabeau E, Earls M, Eason K, Merwin E, Rains G, Tanabe P, Shah N. Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use. J Am Board Fam Med. 2020;33(1):91–105.

Published In

J Am Board Fam Med

DOI

EISSN

1558-7118

Publication Date

2020

Volume

33

Issue

1

Start / End Page

91 / 105

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • North Carolina
  • Middle Aged
  • Medication Adherence
  • Medicaid
  • Infant
  • Hydroxyurea
  • Humans
  • General & Internal Medicine