Researchers developed a mobile app to provide primary care physicians (PCPs) with tools — guidelines, algorithms, and a pathway — needed to communicate effectively with local specialists regarding sickle cell disease.
The team from Duke University and the University of Pittsburgh developed the iOS-based ‘toolkit’ after finding that not all physicians treating sickle cell disease patients were aware of the guidelines, recently updated and issued by a branch of the National Institutes of Health, and few had been in regular communication with a specialist.
They published their findings in the Journal of Primary Care and Community Health, in the study, “Attitudes of Primary Care Physicians toward Sickle Cell Disease Care, Guidelines, and Comanaging Hydroxyurea With a Specialist.”
Researchers partnered with Community Care of North Carolina to identify PCPs assigned to patients with sickle cell disease across the state. In order to better understand the physicians’ attitudes toward sickle cell disease care, awareness of 2014 guidelines, and comfort level at co-administering hydroxyurea with a specialist, they issued a web-based questionnaire to 131 PCPs with at least five sickle cell patients.
The questionnaire included 12 self-reported items with yes-no or 1-5 Likert-type scale answers, assessing attitudes regarding sickle cell disease care and co-management, as well as awareness of the updated guidelines. In total, 53 of these primary care physicians completed the questionnaire.
The researchers concluded that most PCPs were interested in learning about the guidelines and favorable toward co-administering hydroxyurea.
Of the PCPs who responded, 67% reported infrequent communication with a disease specialist and 66% were not aware of the new guidelines. However, 73% reported feeling comfortable with the number of sickle cell patients in their practice, and 76% said they would now frequently refer to the guidelines.
Also, 51% expressed comfort with using mobile apps to access the guidelines and to receiving information via email, and 65% with co-administering hydroxyurea with a 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,” Joseph Lunyera, with Duke University Medical Center, and colleagues wrote in a press release statement. “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.”
Hydroxyurea is strongly recommended for very young patients, ages 9 months to 42 months, and moderately recommended for older children — regardless of clinical severity — to reduce disease complications.
Researchers will now test the app’s feasibility and its acceptance before making it available on iTunes.
“Sickle cell disease is a complex chronic disease requiring care from a multidisciplinary team, including a hematologist, other specialists and PCPs,” Lunyera added. “Because PCPs serve as the major point of contact between patients and the health care system, they are integral to management of sickle cell disease. As such, understanding their perspectives, availing educational resources to them, and leveraging meaningful work relations between PCPs and sickle cell disease specialists is critically important.”