Impact of Telehealth Visit and Socioeconomic Status (SES) on Hydroxyurea
Response in Sickle Cell Anemia
Abstract
Background It is important to ensure access to hydroxyurea (HU) for
patients with sickle cell anemia (SCA) living in rural areas without
easy access to experts in sickle cell management. The UAB Pediatric
Sickle Cell program’s satellite clinics reduce the barrier of
transportation to the university-based clinic. However, as compared to
the university clinic, these satellite clinics do not offer immediate
access to HU dosing laboratory results. Therefore, a nurse clinician
calls families with HU dose adjustments after the completion of the
clinic visit. This study evaluated the impact of telehealth dosing
adjustments on HU laboratory and clinical response as compared to
university-based patients. Methods A one year retrospective chart
reviewed was performed to evaluate HU laboratory and clinical response
based on clinic location and socioeconomic status for patients with SCA.
We identified the number of clinic and acute care visits for one year
and calculated the mean CBC and HbF values for each patient. Results We
identified 107 academic center participants with SCA prescribed HU and
65 satellite clinic participants. We identified no difference in HbF,
Hb, MCV, or ANC by clinic location. We also identified no difference in
hospital admissions based on clinic location. Finally, mean
socioeconomic indicators by zip code were lower in satellite clinic
patients but not associated with a difference in HbF response.
Conclusions The use of telehealth did not negatively impact laboratory
response to HU. Future studies should identify novel approaches to
improve access to HU among patients with SCA living in rural areas.