A multilevel mHealth intervention boosts adherence to hydroxyurea in individuals with sickle cell disease
In: Blood Advances, Jg. 7 (2023-12-12), Heft 23
Online
academicJournal
- 7190 - 7201
Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU Toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval. We enrolled 293 patients (51% male; median age 27.5 years, 86.8% HbSS/HbSβ0-thalassemia). The mean change in PDC among 235 evaluable subjects increased (39.7% to 56.0%; P < 0.001) and sustained (39.7% to 51.4%, P < 0.001). Mean HbF increased (10.95% to 12.78%; P = 0.03). Self-reported pain frequency reduced (3.54 to 3.35 events/year; P = 0.041). InCharge Health was used ≥1 day by 199 of 235 participants (84.7% implementation; median usage: 17% study days; IQR: 4.8-45.8%). For individuals with ≥1 baseline admission for pain, admissions per 24 weeks declined from baseline through 24 weeks (1.97 to 1.48 events/patient, P = 0.0045) and weeks 25-36 (1.25 events/patient, P = 0.0015). PDC increased with app use (P < 0.001), with the greatest effect in those with private insurance (P = 0.0078), older subjects (P = 0.033), and those with lower pain interference (P = 0.0012). Of the 89 providers (49 hematologists, 36 advanced care providers, 4 unreported), only 11.2% used HU Toolbox ≥1/month on average. This use did not affect change in PDC. Tailoring mHealth solutions to address barriers to hydroxyurea adherence can potentially improve adherence and provide clinical benefits. A definitive randomized study is warranted. This trial was registered at www.clinicaltrials.gov as #NCT04080167.
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A multilevel mHealth intervention boosts adherence to hydroxyurea in individuals with sickle cell disease
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Autor/in / Beteiligte Person: | Hankins, Jane S ; Brambilla, Donald ; Potter, Michael B ; Kutlar, Abdullah ; Gibson, Robert ; King, Allison A ; Baumann, Ana A ; Melvin, Cathy ; Gordeuk, Victor R ; Hsu, Lewis L ; Nwosu, Chinonyelum ; Porter, Jerlym S ; Alberts, Nicole M ; Badawy, Sherif M ; Simon, Jena ; Glassberg, Jeffrey A ; Lottenberg, Richard ; DiMartino, Lisa ; Jacobs, Sara ; Fernandez, Maria E ; Bosworth, Hayden B ; Klesges, Lisa M ; Shah, Nirmish ; Hodges, Jason ; Carroll, Yvonne ; Klesges, Lisa ; Khan, Hamda ; Smeltzer, Matthew ; Gurney, James ; Porter, Jerlym ; Alberts, Nicole ; French, Reginald ; Badawy, Sherif ; DeBaun, Michael ; Kang, Guolian ; Estepp, Jeremie ; Wang, Winfred ; Owens, Curtis ; Debon, Margaret ; Osarogiagbon, Ray ; Nelson, Marquita ; Treadwell, Marsha ; Vichinsky, Elliott ; Wun, Ted ; Potter, Michael ; Hessler, Danielle ; Hagar, Ward ; Marsh, Anne ; Neumayr, Lynne ; Kanter, Julie ; Phillips, Shannon ; Adams, Robert ; Mueller, Martina ; Abrams, Tina ; Davia, Nathalia ; Tanabe, Paula ; Bosworth, Hayden ; Jackson, George ; Johnson, Fred ; Richesson, Rachel ; Prvu-Bettger, Janet ; King, Allison ; Baumann, Ana ; Calhoun, Cecilia ; Snyder, Angie ; Fernandez, Maria ; Richardson, Lynne D ; Glassberg, Jeffrey ; Genes, Nicholas G ; Loo, George T ; Shapiro, Jason S ; Souffront, Kimberly ; Clesca, Cindy ; Linton, Elizabeth ; Ryan, Gery ; Kroner, Barbara L ; Hendershot, Tabitha ; Battestilli, Whitney ; Cox, Lisa ; Preiss, Liliana ; Pugh, Norma ; Li, Sophie ; VonLehmden, Annie ; Smith, Sharon M ; Tonkins, William P ; Peters-Lawrence, Marlene ; Boyce, Cheryl ; Barfield, Whitney ; Thompson, Alexis |
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Zeitschrift: | Blood Advances, Jg. 7 (2023-12-12), Heft 23 |
Veröffentlichung: | eScholarship, University of California, 2023 |
Medientyp: | academicJournal |
Umfang: | 7190 - 7201 |
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