Parental and other factors associated with hydroxyurea use for pediatric sickle cell disease

Suzette Olu Busola Oyeku, M. Catherine Driscoll, Hillel W. Cohen, Rebecca Trachtman, Farzana Pashankar, Craig Mullen, Patricia J. Giardina, Nerissa Velazco, Andrew D. Racine, Nancy S. Green

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Hydroxyurea (HU) is highly effective treatment for sickle cell disease (SCD). While pediatric use of HU is accepted clinical practice, barriers to use may impede its potential benefit. Procedure: A survey of parents of children ages 5-17 years with SCD was performed across five institutions to assess factors associated with HU use. Results: Of the 173 parent responses, 65 (38%) had children currently taking HU. Among parents of children not taking HU, the most commonly cited reasons were that their hematology provider had not offered it, their child was not sufficiently symptomatic and concerns about potential side effects. Even parents of HU users reported widespread concern about effectiveness, long-term safety, and off-label use. In bivariate analyses, children's ages, parental demographics such as education level, or travel time to their hematology provider were not correlated with HU use. Bivariate analysis and multivariate logistic regression revealed three significant factors associated with current HU use: better parental knowledge about its major therapeutic effects (P<0.001), sickle genotype (P=0.005), and institution of clinical care (P=0.04). Conclusions: Pervasive concerns about HU safety exist, even among parents of current users. Varying knowledge among parents appears to be independent of their demographics, and is associated with HU use. Inter-institutional variability in parental knowledge and drug uptake highlights potentially potent site-specific influences on likelihood of HU use. Overall, these survey data underscore the need for strategies to bolster parental understanding about benefits of HU and address concerns about its safety.

Original languageEnglish (US)
Pages (from-to)653-658
Number of pages6
JournalPediatric Blood and Cancer
Volume60
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Hydroxyurea
Sickle Cell Anemia
Pediatrics
Parents
Hematology
Safety
Demography
Off-Label Use
Therapeutic Uses
Multivariate Analysis
Logistic Models
Genotype

Keywords

  • Barriers
  • Hydroxyurea
  • Knowledge
  • Outcomes research
  • Sickle cell disease

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Oyeku, S. O. B., Driscoll, M. C., Cohen, H. W., Trachtman, R., Pashankar, F., Mullen, C., ... Green, N. S. (2013). Parental and other factors associated with hydroxyurea use for pediatric sickle cell disease. Pediatric Blood and Cancer, 60(4), 653-658. https://doi.org/10.1002/pbc.24381

Parental and other factors associated with hydroxyurea use for pediatric sickle cell disease. / Oyeku, Suzette Olu Busola; Driscoll, M. Catherine; Cohen, Hillel W.; Trachtman, Rebecca; Pashankar, Farzana; Mullen, Craig; Giardina, Patricia J.; Velazco, Nerissa; Racine, Andrew D.; Green, Nancy S.

In: Pediatric Blood and Cancer, Vol. 60, No. 4, 04.2013, p. 653-658.

Research output: Contribution to journalArticle

Oyeku, SOB, Driscoll, MC, Cohen, HW, Trachtman, R, Pashankar, F, Mullen, C, Giardina, PJ, Velazco, N, Racine, AD & Green, NS 2013, 'Parental and other factors associated with hydroxyurea use for pediatric sickle cell disease', Pediatric Blood and Cancer, vol. 60, no. 4, pp. 653-658. https://doi.org/10.1002/pbc.24381
Oyeku, Suzette Olu Busola ; Driscoll, M. Catherine ; Cohen, Hillel W. ; Trachtman, Rebecca ; Pashankar, Farzana ; Mullen, Craig ; Giardina, Patricia J. ; Velazco, Nerissa ; Racine, Andrew D. ; Green, Nancy S. / Parental and other factors associated with hydroxyurea use for pediatric sickle cell disease. In: Pediatric Blood and Cancer. 2013 ; Vol. 60, No. 4. pp. 653-658.
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abstract = "Background: Hydroxyurea (HU) is highly effective treatment for sickle cell disease (SCD). While pediatric use of HU is accepted clinical practice, barriers to use may impede its potential benefit. Procedure: A survey of parents of children ages 5-17 years with SCD was performed across five institutions to assess factors associated with HU use. Results: Of the 173 parent responses, 65 (38{\%}) had children currently taking HU. Among parents of children not taking HU, the most commonly cited reasons were that their hematology provider had not offered it, their child was not sufficiently symptomatic and concerns about potential side effects. Even parents of HU users reported widespread concern about effectiveness, long-term safety, and off-label use. In bivariate analyses, children's ages, parental demographics such as education level, or travel time to their hematology provider were not correlated with HU use. Bivariate analysis and multivariate logistic regression revealed three significant factors associated with current HU use: better parental knowledge about its major therapeutic effects (P<0.001), sickle genotype (P=0.005), and institution of clinical care (P=0.04). Conclusions: Pervasive concerns about HU safety exist, even among parents of current users. Varying knowledge among parents appears to be independent of their demographics, and is associated with HU use. Inter-institutional variability in parental knowledge and drug uptake highlights potentially potent site-specific influences on likelihood of HU use. Overall, these survey data underscore the need for strategies to bolster parental understanding about benefits of HU and address concerns about its safety.",
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AU - Driscoll, M. Catherine

AU - Cohen, Hillel W.

AU - Trachtman, Rebecca

AU - Pashankar, Farzana

AU - Mullen, Craig

AU - Giardina, Patricia J.

AU - Velazco, Nerissa

AU - Racine, Andrew D.

AU - Green, Nancy S.

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N2 - Background: Hydroxyurea (HU) is highly effective treatment for sickle cell disease (SCD). While pediatric use of HU is accepted clinical practice, barriers to use may impede its potential benefit. Procedure: A survey of parents of children ages 5-17 years with SCD was performed across five institutions to assess factors associated with HU use. Results: Of the 173 parent responses, 65 (38%) had children currently taking HU. Among parents of children not taking HU, the most commonly cited reasons were that their hematology provider had not offered it, their child was not sufficiently symptomatic and concerns about potential side effects. Even parents of HU users reported widespread concern about effectiveness, long-term safety, and off-label use. In bivariate analyses, children's ages, parental demographics such as education level, or travel time to their hematology provider were not correlated with HU use. Bivariate analysis and multivariate logistic regression revealed three significant factors associated with current HU use: better parental knowledge about its major therapeutic effects (P<0.001), sickle genotype (P=0.005), and institution of clinical care (P=0.04). Conclusions: Pervasive concerns about HU safety exist, even among parents of current users. Varying knowledge among parents appears to be independent of their demographics, and is associated with HU use. Inter-institutional variability in parental knowledge and drug uptake highlights potentially potent site-specific influences on likelihood of HU use. Overall, these survey data underscore the need for strategies to bolster parental understanding about benefits of HU and address concerns about its safety.

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