141 - Survey of provider's knowledge and perceptions of Hydroxyurea as a treatment for Sickle Cell disease.

Poster Number: 141
Publication Number: 141.304

Jonathan N. Hooshmand, New York Department of Health, Schenectady, NY, United States; Paloma Luisi, New York State Department of Health, Albany, NY, United States; Lindsay Cogan, Office of Quality and Patient Safety, NYSDOH, Albany, NY, United States; Marcy Stein-Albert, Icahn School of Medicine at Mount Sinai, Jamaica, NY, United States; Jean-Bernard Poulard, Icahn School of Medicine at Mount Sinai, Jamaica, NY, United States; Kenneth Rivlin, NYC Health+Hospitals/Jacobi, Bronx, NY, United States

Background: Children represent 40% of the Medicaid Sickle Cell disease (SCD) population and the majority (70%) live in New York City (New York State Medicaid Data warehouse, n.d.). Previous research found that low awareness of or agreement regarding the benefits of hydroxyurea led to under prescribing of hydroxyurea (HU) or low adherence to the National Heart, Lung, and Blood Institute (NHLBI) guideline for HU treatment counseling (Lanzkron et al., 2008; Cabana et al., 2019). This survey examines provider’s knowledge and perceptions of hydroxyurea as a treatment for SCD for use in future interventions which plan to increase hydroxyurea counseling and prescribing.

Objective: Understand provider's baseline knowledge of hydroxyurea as a disease modifying therapy for Sickle Cell disease.

Design/Methods: The Qualtrics survey was launched from June 2021 to July 31st, 2021. A survey link was e-mailed to pediatric emergency department, pediatric primary care, and pediatric hematology physicians and clinical providers who are part of New York City’s Health and Hospitals system. There were 85 responses to the survey. Seven (7) individuals declined to participate and there were 238 non-respondents out of 330 eligible physicians and clinical providers.

Results: The survey found that 89% of ER and PCP providers who responded agreed that HU was ‘a safe and efficacious treatment for children with SCD’ and 65% agreed they had ‘a baseline knowledge and comfort around HU’. However, only 37% ‘feel it is within their role to recommend HU’ and 25% ‘feel confident in [their] my ability to counsel and advise patients and their families on HU’. Only 57% agreed that ‘HU should be recommended to all children with SCD’ and 29% neither agreed nor disagreed with that statement. Only 35% agreed when asked if they ‘know how to identify potential adverse reactions for patients on HU’ and 26% agreed that they ‘know how to monitor patients on HU’. When asked if they had ‘fears or concerns about cancer, birth defects, infertility, and the uncertainty of long-term risks of HU’; 24% agreed, 35% were neutral, and 37% disagreed with the statement.Conclusion(s): The initial findings from this survey indicate that there is familiarity with HU as a treatment for SCD but there is also uncertainty. This may indicate a lack of knowledge even though HU has been a treatment guideline for SCD for over a decade.  Lack of confidence about the ability to counsel patients and fears about the long-term risks of HU indicate a need for provider education on HU given that there is no evidence of long-term risks associated with HU use from previous clinical trials.