Attitudes toward Management of Sickle Cell Disease and Its Complications: A National Survey of Academic Family Physicians.

Arch G Mainous,Richard Baker,Navkiran K Shokar,Rebecca J Tanner,Christopher A Harle,Mary M Hulihan

doi:10.1155/2015/853835

Abstract

Objective. Sickle cell disease (SCD) is a disease that requires a significant degree of medical intervention, and family physicians are one potential provider of care for patients who do not have access to specialists. The extent to which family physicians are comfortable with the treatment of and concerned about potential complications of SCD among their patients is unclear. Our purpose was to examine family physician's attitudes toward SCD management. Methods. Data was collected as part of the Council of Academic Family Medicine Educational Research Alliance (CERA) survey in the United States and Canada that targeted family physicians who were members of CERA-affiliated organizations. We examined attitudes regarding management of SCD. Results. Overall, 20.4% of respondents felt comfortable with treatment of SCD. There were significant differences in comfort level for treatment of SCD patients depending on whether or not physicians had patients who had SCD, as well as physicians who had more than 10% African American patients. Physicians also felt that clinical decision support (CDS) tools would be useful for treatment (69.4%) and avoiding complications (72.6%) in managing SCD patients. Conclusions. Family physicians are generally uncomfortable with managing SCD patients and recognize the utility of CDS tools in managing patients.

Highlights

Sickle cell disease (SCD) affects millions of people throughout the world and is common among those whose ancestors came from sub-Saharan Africa; Spanish-speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America); Saudi Arabia; India; and Mediterranean countries such as Turkey, Greece, and Italy
The majority of physicians had no SCD patients, and only 15.9% had more than five SCD patients
Few physicians had a substantial proportion of African American patients, with only 25.7% reporting 25% or more African American patients

Summary

Introduction

Sickle cell disease (SCD) affects millions of people throughout the world and is common among those whose ancestors came from sub-Saharan Africa; Spanish-speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America); Saudi Arabia; India; and Mediterranean countries such as Turkey, Greece, and Italy. It is estimated that SCD affects 90,000 to 100,000 Americans, and sickle cell trait occurs among 1 in 12 African Americans [1]. Patients with sickle cell disease require comprehensive care including preventive interventions, pain management, hydroxyurea, and blood transfusions [2]. Due to the complex and disabling nature of sickle cell disease, appropriate ambulatory management is critical to avoid acute pain and vasoocclusive episodes and hospitalizations.

Methods

Results

Conclusion