Feasibility and preliminary outcomes of an integrated pediatric sickle cell disease and pulmonary care clinic for children with sickle cell disease

Background In children with sickle cell disease (SCD), comorbid asthma is associated with increased disease severity and morbidity, but it remains underdiagnosed and optimal management paradigms are not well defined. The purpose of this study was to determine the feasibility and preliminary outcomes...

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Bibliographic Details
Published in:Pediatric blood & cancer 2020-11, Vol.67 (11), p.e28672-n/a
Main Authors: Black, L. Vandy, Ezmigna, Dima, Wallace‐Farquharson, Tanya, Wilkie, Diana J., Duckworth, Laurie
Format: Article
Language:English
Subjects:
Adolescent
Anemia, Sickle Cell - complications
Apnea
Asthma
Asthma - etiology
Asthma - therapy
Blood transfusion
Child
Child, Preschool
Children
Delivery of Health Care, Integrated - methods
Erythrocytes
Feasibility Studies
Female
Follow-Up Studies
Hematology
Humans
integrated chronic care model
Interdisciplinary aspects
Lung diseases
Male
Morbidity
Oncology
Patient Care Team - standards
Patients
Pediatrics
Prognosis
quality
Quality control
Quality Improvement - standards
Respiratory function
Respiratory Function Tests
Sickle cell disease
Sleep
Sleep disorders
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Summary:Background In children with sickle cell disease (SCD), comorbid asthma is associated with increased disease severity and morbidity, but it remains underdiagnosed and optimal management paradigms are not well defined. The purpose of this study was to determine the feasibility and preliminary outcomes of an integrated pediatric SCD and pulmonary care clinic in children with SCD. Methods We implemented a pre‐post quality improvement (QI) project in our pediatric hematology clinic between 2017 and 2019. Guided by the chronic care model, patients who were ages 2‐18 years, diagnosed with SCD and suspected pulmonary comorbidities, received care in an interdisciplinary clinic. We examined feasibility and compared clinical outcomes to 24 months prior (2015‐2017) to the implementation of the integrated care model. Results Twenty‐four patients were included in the QI project: 88% (n = 21) received pulmonary function testing, 92% (n = 22) were diagnosed with asthma, and 33% (n = 8) with obstructive sleep apnea. Adherence to pulmonary appointments was increased by 81% (mean difference [MD] = 1.3, 95% confidence interval [CI] = 0.71‐1.92; P 
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.28672