Research Identifies Need for Improved Understanding of Sickle Cell Disease in... (zed in a Florida Medicaid population [Ab...)

Research Identifies Need for Improved Understanding of Sickle Cell Disease in Adulthood

Date:12/8/2007

zed in a Florida Medicaid population [Abstract #79]

Richard Lottenberg, MD, Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL

This retrospective cohort study aimed to determine adoption and utilization of hydroxyurea therapy in sickle cell disease among 2,301 Florida Medicaid-eligible patients over 16 years of age. It found that the prevalence of hydroxyurea use in this Medicaid population is low. Hydroxyurea adoption was determined by the presence of at least one hydroxyurea pharmacy claim and about 17 percent of the patients had at least one pharmacy claim for hydroxyurea. Hydroxyurea users compared to non-hydroxyurea users were more likely to be males, older than 25, with a history of using slow-release opioid medications, or receiving red cell transfusions. A substantial number of patients that met FDA-approved criteria for hydroxyurea did not receive it. The study also found that early therapy drop-out and low adherence rates were common in patients prescribed hydroxyurea. These findings highlight the need to develop programs to enhance physician adoption and prescribing of hydroxyurea, as well as educational materials to increase patient adherence.

-- First-ever evaluation of hydroxyurea use in Nigerian population shows absolute lack of use by physicians in area with highest incidence of sickle cell disease worldwide [Abstract #80]

Zakari Aliyu, MD, MPH, Center for Sickle Cell Disease, Howard University, Washington, DC

This prospective trial included interviews with 206 adult and pediatric sickle cell patients and 10 hematologists, and reviewed data from more than 1,000 patients, all based in Nigeria, about hydroxyurea utilization. The study found that 100 percent of the Nigerian hematologists surveyed reported discomfort with instituting hydroxyurea as a treatment option for sickle cell disease patients. Barriers to hydroxyurea utilization identified by physicians included safe
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