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The Longitudinal Relationship of HU Adherence to HRQOL, Barriers to Adherence and Habit in SCD.

Not Applicable
Active, not recruiting
Conditions
Sickle Cell Hemoglobin C
Sickle B+ Thalassemia
Sickle Cell Disease
Sickle Beta Zero Thalassemia
Interventions
Other: HU-Go app
Registration Number
NCT04691323
Lead Sponsor
Ann & Robert H Lurie Children's Hospital of Chicago
Brief Summary

The primary objective of this study is to better understand factors contributing to variations in hydroxyurea (HU) adherence behavior in adolescents and young adults (AYA) with sickle cell disease (SCD). To meet this objective, the researchers will conduct a prospective cohort study to determine the longitudinal relationship between HU adherence and health-related quality of life (HRQOL) overtime among AYA with SCD. The long-term goal of this research is to promote medication adherence behavior and improve health outcomes in AYA with SCD.

Detailed Description

Sickle cell disease is the most common genetic disorder in the US, affecting about 100,000 Americans, and about 1 in 400 African American live births, incurring annual health care costs of $335 million. SCD can lead to serious complications including unpredictable, debilitating pain episodes, cardiopulmonary disease, stroke, and long-term end organ damage.These complications lead to significant declines in health-related quality of life (HRQOL) and other patient-reported outcomes (PROs), culminating in early mortality, particularly among AYA. Hydroxyurea, at present, is the main FDA approved medication for SCD that reduces morbidity and mortality, improves HRQoL and lowers healthcare utilization.However, adherence to HU remains suboptimal with only 35-50% of patients achieving high adherence (≥90%), particularly among AYA with SCD. Low HU adherence has been associated with worse health outcomes, poor HRQOL and increased healthcare utilization. Low HU adherence is multifactorial, especially in AYA with other competing priorities and vulnerability in developmental and psychological factors contributing to adherence behavior. The specific aim for this study is to determine the longitudinal relationship of HU adherence behavior to health-related quality of life, barriers to adherence and habit formation among AYA with SCD.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
68
Inclusion Criteria
  • Age 12-21 years old
  • Any sickle cell disease genotype
  • On steady state of hydroxyurea for 2 months
  • Own or have access to a smartphone
  • Parents of patients that meet the eligibility criteria and are enrolled in the study will be included
Exclusion Criteria
  • Patients with recent hospitalizations within the past 7 days

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
HU-Go app intervention armHU-Go appParticipants will use the HU-Go app intervention arm for 12 months.
Primary Outcome Measures
NameTimeMethod
Hydroxyurea adherence rate12 months

Adherence rate is defined as number of given HU doses given, as captured by HU-Go app, divided by total number of doses expected during study period.

Secondary Outcome Measures
NameTimeMethod
Physical function score using Patient reported outcomes measurement information system (PROMIS) measure12 months

Patient reported outcomes measurement information system (PROMIS) measure for physical function, numerical value on a scale of 0-100 points, normal average for the general population is 50 with standard deviation of 10 points (lower T scores indicating worse physical function).

Depression score using Patient reported outcomes measurement information system (PROMIS) measure12 months

Patient reported outcomes measurement information system (PROMIS) measure for depression, numerical value on a scale of 0-100 points, normal average for the general population is 50 with standard deviation of 10 points (higher T scores indicating worse depression).

Anxiety score using Patient reported outcomes measurement information system (PROMIS) measure12 months

Patient reported outcomes measurement information system (PROMIS) measure for anxiety, numerical value on a scale of 0-100 points, normal average for the general population is 50 with standard deviation of 10 points (higher T scores indicating worse anxiety).

Peer relationships score using Patient reported outcomes measurement information system (PROMIS) measure12 months

Patient reported outcomes measurement information system (PROMIS) measure for peer relationships, numerical value on a scale of 0-100 points, normal average for the general population is 50 with standard deviation of 10 points (lower T scores indicating worse peer relationships).

Adherence to Hydroxyurea using PROMIS Medication Adherence Scale (PMAS)12 months

Higher score indicating higher adherence to hydroxyurea

Adherence to Hydroxyurea using Visual Analogue Scale12 months

Numerical value on a scale 0-100% (higher score indicating higher adherence to hydroxyurea)

Pain score using Patient reported outcomes measurement information system (PROMIS) measure12 months

Patient reported outcomes measurement information system (PROMIS) measure for pain intensity, numerical value on a scale of 0-100 points, normal average for the general population is 50 with standard deviation of 10 points (higher T scores indicating worse pain).

Fatigue score using Patient reported outcomes measurement information system (PROMIS) measure12 months

Patient reported outcomes measurement information system (PROMIS) measure for fatigue, numerical value on a scale of 0-100 points, normal average for the general population is 50 with standard deviation of 10 points (higher T scores indicating worse fatigue).

Codes and themes from qualitative data analysis12 months

Semi-structured interviews focused on HU taking behavior, barriers to adherence and habit formation

Trial Locations

Locations (1)

Ann & Robert H Lurie Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

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