Hydroxyurea in children with sickle cell disease: practice patterns and barriers to utilization. Am J Hematol 2010 Aug;85(8):611-3
Date
07/27/2010Pubmed ID
20658592Pubmed Central ID
PMC2911651DOI
10.1002/ajh.21749Scopus ID
2-s2.0-77955490414 (requires institutional sign-in at Scopus site) 76 CitationsAbstract
Hydroxyurea (HU) is underutilized in adults with sickle cell disease (SCD) despite the Multicenter Study of Hydroxyurea in Sickle Cell Anemia (MSH) (1). Since little is known about HU utilization in children with SCD we sought to: 1) evaluate patterns of HU utilization; 2) elicit how providers define frequent pain when prescribing HU; and 3) identify barriers to HU use by surveying members of the American Society of Pediatric Hematology/Oncology. Data analysis included descriptive statistics and Chi-square. Of the 350 respondents, 63% care for SCD patients. Of these providers, only 9% have 50–90% of patients on HU, while 10% have <10% on HU. Criteria used to initiate HU included acute chest syndrome and frequent pain. Approximately half of providers account only for pain requiring hospitalization when prescribing HU. Those accounting for pain managed at home were more likely to have >30% of patients on HU (35.2% vs. 20%; p=0.023; Chi-square). Provider-related barriers to prescribing HU included compliance with: HU (86%), laboratory monitoring (85%), and contraception (85%). Our survey suggests substantial variation in HU utilization in children. Providers accounting for pain managed both in and out of the hospital had more patients on HU. Existing barriers to HU utilization should be addressed to optimize care for children with SCD.
Author List
Brandow AM, Jirovec DL, Panepinto JAAuthor
Amanda Brandow DO Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anemia, Sickle CellAttitude of Health Personnel
Child
Contraception
Data Collection
Drug Monitoring
Drug Utilization
Female
Guideline Adherence
Hematology
Hospitalization
Humans
Hydroxyurea
Male
Medical Oncology
Pain
Patient Compliance
Pediatrics
Physicians
Practice Patterns, Physicians'
