Duke University School of Nursing, Durham, NC, USA.
Duke University School of Medicine, Durham, NC, USA.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211049050. doi: 10.1177/21501327211049050.
Sickle cell disease (SCD) is a complex chronic blood disorder characterized by severe disease complications ideally managed by both hematologists and primary care providers (PCP's). PCP's report knowledge gaps and discomfort with SCD management. Our team developed and a decision support tool for SCD management (SCD Toolbox) based on the National Heart, Lung, and Blood Institute's SCD guidelines. We surveyed PCPs in North Carolina (NC) prior to formal dissemination to determine current co-management practices, assess toolbox acceptability, use, format preferences, and understand which algorithms would be most helpful.
A 23-item baseline needs assessment survey was disseminated to PCPs throughout NC.
A total of 63 medical providers responded to the survey and of these respondents, 64% reported caring for 1 to 10 patients with SCD. Only 39% of PCPs reported regular communication with an SCD specialist. Providers reported the highest level of awareness of the pediatric and adult health maintenance tools (41% and 39% respectively) and highest use of the pediatric (26%) and adult (28%) health maintenance tools. Respondents also expressed a desire to have access to multiple toolbox formats (37%) (website, mobile app and/or paper).
The use of a convenience sample and low survey response are study limitations which hinder generalizability.
PCPs rarely co-managed with a specialist, had low awareness and use of SCD toolbox, and requested multiple formats for the toolbox.
镰状细胞病(SCD)是一种复杂的慢性血液病,其严重的疾病并发症理想情况下应由血液学家和初级保健提供者(PCP)共同管理。PCP 报告称存在知识差距,并对 SCD 管理感到不适。我们的团队根据美国国立心肺血液研究所的 SCD 指南,为 SCD 管理开发了一个决策支持工具(SCD 工具箱)。我们在正式传播之前对北卡罗来纳州的 PCP 进行了调查,以确定当前的共同管理实践,评估工具包的可接受性、使用情况、格式偏好,并了解哪些算法最有帮助。
向北卡罗来纳州的 PCP 分发了一份包含 23 个项目的基线需求评估调查。
共有 63 名医疗保健提供者对该调查做出了回应,其中 64%的人表示照顾了 1 到 10 名 SCD 患者。只有 39%的 PCP 表示定期与 SCD 专家沟通。提供者报告说,他们对儿科和成人健康维护工具的认识水平最高(分别为 41%和 39%),使用最多的是儿科(26%)和成人(28%)健康维护工具。受访者还表示希望获得多种工具箱格式(37%)(网站、移动应用程序和/或纸质)。
使用便利样本和低调查回应率是研究的局限性,限制了研究的普遍性。
PCP 很少与专家共同管理,对 SCD 工具箱的认识和使用程度较低,并要求工具箱提供多种格式。