Disseminating NIH Evidence Based Sickle Cell Recommendations in North Carolina

Study Overview
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Brief Summary
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This project will improve the efficiency and quality of healthcare for persons with sickle cell disease, an under-served and at risk population by implementing a co-management model of care. Many patients with sickle cell disease (SCD) receive care primarily from specialty physicians and emergency departments (ED), thus resulting in a lack of primary care and a high number of ED visits and hospitalizations. The goal is to improve PCP and SCD specialist co-management. The overall purpose of this dissemination project is to evaluate utilization data, as well as patient and provider reported outcomes associated with the dissemination of a toolbox of decision support tools to PCP's and ED providers across NC and SC.

Detailed Description
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The investigators will achieve the goals stated above through three aims. Examine the effects of decision support tools on study outcomes during the 12 months prior to project start and across the 3.5 years of the project in NC and SC. The investigators will also determine which patient and practice level characteristics predict study outcomes. Evaluate individual provider-reported awareness, use and preference of health maintenance tables and algorithms amongst PCPs and ED providers in NC and SC at project start and yearly across the project. Additionally, the investigators will explore patient reported awareness of and satisfaction with co-management model of care in NC and SC. The investigators will conduct an exploratory cost analysis of the dissemination and implementation of the SCD co-management model and its effect on healthcare resource utilization.

Official Title
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Disseminating NIH Evidence Based Sickle Cell Recommendations in North Carolina

Conditions
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Sickle Cell Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient with diagnosis of sickle cell disease, emergency department clinician, or primary care clinician in the state of NC or part of SC Exclusion Criteria: Non-English speaking, non-resident of NC or SC
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| State<br>North Carolina | |
| SCD Patients<br> | |
| Providers<br>Primary care and emergency department clinicians | |
| Year<br>Baseline, year 2, year 3 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HU refills | number of hydroxyurea prescription refills per patient | 12 months | 
| Co-management visits | number of co-management visits per patient | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ED visits | number of visits to the emergency department per patient | 12 months | 
| In-patient hospitalizations | number of in-patient hospitalizations per patient | 12 months | 
| Re-admission to hospital within 30 days | number of re-admissions per patient over the course of one year | 12 months | 
| Primary care visits | number of visits to primary care provider per patient | 12 months | 
| Specialty visits | number of specialty care visits per patient | 12 months | 
| Transcranial doppler screening | number of transcranial doppler screenings per patient | 12 months | 
| Opioid prescription fills | number of opioid prescription fill days per patient | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Co-management, Co-management model of care, Primary Care, Specialty Care, Decision support tools, Emergency Department Clinicians