Skip to main content
Journal cover image

Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease.

Publication ,  Journal Article
Knight, LMJ; Tanabe, P; Blewer, AL; Goodrich, J; King, AA; Reuter-Rice, K; Crego, N
Published in: Pediatr Blood Cancer
July 2024

BACKGROUND: National sickle cell disease (SCD) guidelines recommend oral hydroxyurea (HU) starting at 9 months of age, and annual transcranial Doppler (TCD) screenings to identify stroke risk in children aged 2-16 years. We examined prevalence and proportion of TCD screenings in North Carolina Medicaid enrollees to identify associations with sociodemographic factors and HU adherence over 3 years. STUDY DESIGN: We conducted a longitudinal study with children ages 2-16 years with SCD enrolled in NC Medicaid from years 2016-2019. Prevalence of TCD screening claims was calculated for 3 years, and proportion was calculated for 12, 24, and 36 months of Medicaid enrollment. Enrollee HU adherence was categorized using HU proportion of days covered. Multivariable Poisson regression assessed for TCD screening rates by HU adherence, controlling for age, sex, and rurality. RESULTS: The prevalence of annual TCD screening was between 39.5% and 40.1%. Of those with 12-month enrollment, 77.8% had no TCD claims, compared to 22.2% who had one or higher TCD claims. Inversely, in children with 36 months of enrollment, 36.7% had no TCD claims compared to 63.3% who had one or higher TCD claims. The proportion of children with two or higher TCD claims increased with longer enrollment (10.5% at 12 months, 33.7% at 24 months, and 52.6% at 36 months). Children with good HU adherence were 2.48 (p < .0001) times more likely to have TCD claims than children with poor HU adherence. CONCLUSION: While overall TCD screening prevalence was low, children with better HU adherence and longer Medicaid enrollment had more TCD screenings. Multilevel interventions are needed to engage healthcare providers and families to improve both evidence-based care and annual TCD screenings in children with SCD.

Duke Scholars

Published In

Pediatr Blood Cancer

DOI

EISSN

1545-5017

Publication Date

July 2024

Volume

71

Issue

7

Start / End Page

e31017

Location

United States

Related Subject Headings

  • United States
  • Ultrasonography, Doppler, Transcranial
  • Stroke
  • Prognosis
  • Oncology & Carcinogenesis
  • North Carolina
  • Medication Adherence
  • Medicaid
  • Male
  • Longitudinal Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Knight, L. M. J., Tanabe, P., Blewer, A. L., Goodrich, J., King, A. A., Reuter-Rice, K., & Crego, N. (2024). Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease. Pediatr Blood Cancer, 71(7), e31017. https://doi.org/10.1002/pbc.31017
Knight, La’Kita M. J., Paula Tanabe, Audrey L. Blewer, James Goodrich, Allison A. King, Karin Reuter-Rice, and Nancy Crego. “Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease.Pediatr Blood Cancer 71, no. 7 (July 2024): e31017. https://doi.org/10.1002/pbc.31017.
Knight LMJ, Tanabe P, Blewer AL, Goodrich J, King AA, Reuter-Rice K, et al. Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease. Pediatr Blood Cancer. 2024 Jul;71(7):e31017.
Knight, La’Kita M. J., et al. “Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease.Pediatr Blood Cancer, vol. 71, no. 7, July 2024, p. e31017. Pubmed, doi:10.1002/pbc.31017.
Knight LMJ, Tanabe P, Blewer AL, Goodrich J, King AA, Reuter-Rice K, Crego N. Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease. Pediatr Blood Cancer. 2024 Jul;71(7):e31017.
Journal cover image

Published In

Pediatr Blood Cancer

DOI

EISSN

1545-5017

Publication Date

July 2024

Volume

71

Issue

7

Start / End Page

e31017

Location

United States

Related Subject Headings

  • United States
  • Ultrasonography, Doppler, Transcranial
  • Stroke
  • Prognosis
  • Oncology & Carcinogenesis
  • North Carolina
  • Medication Adherence
  • Medicaid
  • Male
  • Longitudinal Studies