ArticleJournal of the American Board of Family Medicine : JABFM
Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use.
Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Medical and Non-medical Costs of Sickle Cell Disease and Treatments from a US Perspective: A Systematic Review and Landscape Analysis.PharmacoEconomics - open · 2022Pooled it
- Economic Burden of Sickle Cell Disease: A Retrospective Study of Pediatric and Adult Individuals With Medicaid Coverage From 2016 to 2020.American journal of hematology · 2026Article
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- Design and Refinement of CyberCellJournal of medical extended reality · 2025Review
- Redefining High Emergency Department Utilization for Sickle Cell Disease.JAMA network open · 2025Article
- Hydroxyurea utilization among individuals with sickle cell disease in Tennessee: a pooled analysis of claims data.Frontiers in pharmacology · 2025Article
- Management of diabetes mellitus patients with sickle cell anemia: Challenges and therapeutic approaches.Medicine · 2024Review
- Contraception, pregnancy, and STI counseling and care among transitioning young adults with sickle cell disease.Blood advances · 2023Article
- Defining global strategies to improve outcomes in sickle cell disease: a Lancet Haematology Commission.The Lancet. Haematology · 2023Review
- Changes in Hydroxyurea Use Among Youths Enrolled in Medicaid With Sickle Cell Anemia After 2014 Revision of Clinical Guidelines.JAMA network open · 2023Article
- Lifetime medical costs attributable to sickle cell disease among nonelderly individuals with commercial insurance.Blood advances · 2023Article
- Genotypic and Phenotypic Composition of Sickle Cell Disease in the Arab Population - A Systematic Review.Pharmacogenomics and personalized medicine · 2023Review
- Higher hydroxyurea adherence among young adults with sickle cell disease compared to children and adolescents.Annals of medicine · 2022Article
- Surveillance for Sickle Cell Disease - Sickle Cell Data Collection Program, Two States, 2004-2018.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2022Article
- Hematologist encounters among Medicaid patients who have sickle cell disease.Blood advances · 2022Article
- Outcome of Hydroxyurea Use in SCD and Evaluation of Patients' Perception and Experience in Nigeria.Frontiers in genetics · 2022Article
- Dissemination of Evidence-Based Recommendations for Sickle Cell Disease to Primary Care and Emergency Department Providers in North Carolina: A Cost Benefit Analysis.Journal of health economics and outcomes research · 2021Article
- Administrative data identify sickle cell disease: A critical review of approaches in U.S. health services research.Pediatric blood & cancer · 2020Review
- Awareness and Use of the Sickle Cell Disease Toolbox by Primary Care Providers in North Carolina.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundSickle-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.
methodsData 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.
resultsThere 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.
conclusionComanagement 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.
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