TY - JOUR
T1 - Global geographic differences in healthcare utilization for sickle cell disease pain crises in the CASiRe cohort
AU - Strunk, Crawford
AU - Tartaglione, Immacolata
AU - Piccone, Connie M.
AU - Colombatti, Raffaella
AU - Andemariam, Biree
AU - Manwani, Deepa
AU - Smith, Ashya
AU - Haile, Haikel
AU - Kim, Esther
AU - Wilson, Samuel
AU - Asare, Eugenia Vicky
AU - Rivers, Angela
AU - Farooq, Fatimah
AU - Urbonya, Rebekah
AU - Boruchov, Donna
AU - Boatemaa, Gifty Dankwah
AU - Perrotta, Silverio
AU - Ekem, Ivy
AU - Sainati, Laura
AU - Rao, Sudha
AU - Zempsky, William
AU - Sey, Fredericka
AU - Antwi-Boasiako, Charles
AU - Segbefia, Catherine
AU - Inusa, Baba
AU - Campbell, Andrew D.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Sickle cell disease (SCD) is characterized by frequent, unpredictable pain episodes and other vaso-occlusive crises (VOCs) leading to significant healthcare utilization. VOC frequency is often an endpoint in clinical trials investigating novel therapies for this devastating disease. Procedure: The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaboration investigating clinical severity in SCD using a validated questionnaire and medical chart review standardized across four countries (United States, United Kingdom, Italy and Ghana). Results: This study, focused on pain crisis incidence and healthcare utilization, included 868 patients, equally represented according to age and gender. HgbSS was the most common genotype. Patients from Ghana used the Emergency Room/Day Hospital for pain more frequently (annualized mean 2.01) than patients from other regions (annualized mean 1.56 U.S.; 1.09 U.K.; 0.02 Italy), while U.K. patients were hospitalized for pain more often (annualized mean: U.K. 2.98) than patients in other regions (annualized mean 1.98 U.S.; 1.18 Ghana; Italy 0.54). Italy's hospitalization rate for pain (annualized mean: 0.57) was nearly 20 times greater than its emergency room/day hospital only visits for pain (annualized mean: 0.03). When categorized by genotype and age, similar results were seen. Conclusions: Geographic differences in pain crisis frequency and healthcare utilization may correlate with variable organization of healthcare systems among countries and should be considered regarding trial design, endpoints, and analysis of results when investigating novel agents for clinical benefit.
AB - Background: Sickle cell disease (SCD) is characterized by frequent, unpredictable pain episodes and other vaso-occlusive crises (VOCs) leading to significant healthcare utilization. VOC frequency is often an endpoint in clinical trials investigating novel therapies for this devastating disease. Procedure: The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaboration investigating clinical severity in SCD using a validated questionnaire and medical chart review standardized across four countries (United States, United Kingdom, Italy and Ghana). Results: This study, focused on pain crisis incidence and healthcare utilization, included 868 patients, equally represented according to age and gender. HgbSS was the most common genotype. Patients from Ghana used the Emergency Room/Day Hospital for pain more frequently (annualized mean 2.01) than patients from other regions (annualized mean 1.56 U.S.; 1.09 U.K.; 0.02 Italy), while U.K. patients were hospitalized for pain more often (annualized mean: U.K. 2.98) than patients in other regions (annualized mean 1.98 U.S.; 1.18 Ghana; Italy 0.54). Italy's hospitalization rate for pain (annualized mean: 0.57) was nearly 20 times greater than its emergency room/day hospital only visits for pain (annualized mean: 0.03). When categorized by genotype and age, similar results were seen. Conclusions: Geographic differences in pain crisis frequency and healthcare utilization may correlate with variable organization of healthcare systems among countries and should be considered regarding trial design, endpoints, and analysis of results when investigating novel agents for clinical benefit.
KW - Complications
KW - Geographic differences
KW - Health resources utilization
KW - Pain crisis
KW - Sickle cell disease
UR - http://www.scopus.com/inward/record.url?scp=85115603333&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85115603333&partnerID=8YFLogxK
U2 - 10.1016/j.bcmd.2021.102612
DO - 10.1016/j.bcmd.2021.102612
M3 - Article
C2 - 34564050
AN - SCOPUS:85115603333
SN - 1079-9796
VL - 92
JO - Blood Cells, Molecules, and Diseases
JF - Blood Cells, Molecules, and Diseases
M1 - 102612
ER -