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Ambulatory quality indicators to prevent infection in sickle cell disease. Am J Hematol 2014 Mar;89(3):256-60

Date

04/30/2014

Pubmed ID

24779032

Pubmed Central ID

PMC4450348

DOI

10.1002/ajh.23627

Scopus ID

2-s2.0-84896894640 (requires institutional sign-in at Scopus site)   38 Citations

Abstract

The purpose of this study was to identify rates of adherence for three outpatient quality indicators noted by Wang et al. (Pediatrics 2011;128:484–493): (1) influenza vaccine, (2) pneumococcal immunizations, and (3)penicillin prophylaxis in patients with sickle cell disease (SCD) in a Medicaid sample. These variables were chosen based on Wang and colleagues' suggestion that these variables are important for the assessment of the quality of care of children with SCD. We hypothesized that the overall rate of adherence would be poor with adults having worse rates of adherence than children. We conducted a retrospective cohort study using the Wisconsin State Medicaid database over a 5-year period to assess the preventative medication adherence of individuals with SCD. Preventative medication variables in this study included influenza vaccination,pneumococcal immunizations (PCV7, PPV23), and penicillin prophylaxis. As predicted, the 2003–2007 Wisconsin State Medicaid database showed patients with SCD had low adherence in terms of recommended influenza vaccinations (21.58% adherent), PPV23 pneumococcal immunizations (43.47% adherent), and penicillin prophylaxis (18.18% adherent). Pneumococcal immunizations for PCV7 were higher than expected (77.27%adherent). Although children tended to adhere to recommended preventative medications more than adults,overall adherence was low. Although we cannot explain why adherence is low, it is likely due to multiple factors at the patient- and provider-level. We encourage patients and providers to create a partnership to meet adherence recommendations, and we describe our strategies for increasing adherence.

Author List

Beverung LM, Brousseau D, Hoffmann RG, Yan K, Panepinto JA

Author

Ke Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Anemia, Sickle Cell
Antibiotic Prophylaxis
Child
Child, Preschool
Humans
Infant
Influenza Vaccines
Medicaid
Patient Compliance
Penicillins
Pneumococcal Vaccines
Quality Indicators, Health Care
United States
Vaccination
Young Adult