Researchers from Duke University and the University of Pittsburgh have developed a mobile app to provide PCPs with guidelines, algorithms and a way to communicate with local specialist regarding sickle cell disease.
The team developed the iOS-based “toolkit” after finding that few PCPs serving patients with the disease were aware of new sickle cell guidelines, or had been in regular communication with a specialist. Publishing their data in the Journal of Primary Care and Community Health, they further concluded that a majority of PCPs nonetheless have a favorable attitude toward learning about the guidelines and co-administering hydroxyurea with a specialist. The researchers plan to test the app’s feasibility and acceptability among PCPs before making it available through iTunes.
“Sickle cell disease (SCD) is a complex chronic disease requiring care from a multidisciplinary team, including a hematologist, other specialists and [PCPs],” Joseph Lunyera, MBChB, MSc, of Duke University Medical Center, in Durham, North Carolina, and colleagues wrote. “… Because PCPs serve as the major point of contact between patients and the health care system, they are integral to management of SCD. As such, understanding their perspectives, availing educational resources to them, and leveraging meaningful work relations between PCPs and SCD specialists is critically important in formulating a comprehensive and coordinated SCD care system.”
To better understand PCP attitudes toward SCD care, awareness of 2014 guidelines, and comfort at the prospect of co-administering hydroxyurea with a specialist, the researchers partnered with Community Care of North Carolina to identify PCPs assigned to patients with SCD, and Medicaid, across the state. Network administrators administered a web-based questionnaire among 131 PCPs who had at least five patients with SCD.
The questionnaire included 12 self-reported items with a yes-no or 1 to 5 Likert-type scale, assessing attitudes regarding SCD care and co-management, and awareness of guidelines. Fifty-three PCPs completed the questionnaire.
According to the researchers, 73% of those who completed the questionnaire reported feeling comfortable with the number of patients with SCD in their practice. However, 67% reported having infrequent communications with an SCD specialist, and 66% were unaware of the 2014 SCD guidelines. Still, 76% said they would frequently refer to the guidelines once made aware, and 51% expressed comfort with using mobile apps to access them and receiving further information via email. In addition, 65% reported being comfortable co-administering hydroxyurea with an SCD specialist.
“PCPs in North Carolina demonstrated a favorable attitude toward receiving the SCD guidelines and co-managing hydroxyurea with a specialist, yet few of them currently were aware of these guidelines or had regular communication with an SCD specialist,” Lunyera and colleagues wrote. “In response to this gap in care, we have now developed a mobile-based SCD toolbox specifically to assist PCPs to utilize SCD guidelines, algorithms, and a method to communicate with SCD specialists.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.