The Public Health Data and Training Center at the Institute for Public Health at Washington University in St. Louis has been working with Allison King, MD, MPH, institute scholar and assistant professor in the Washington University School of Medicine in St. Louis, on a project to help improve care to patients with sickle cell disease (SCD).
In 2014, Dr. King received a 2.45 million dollar, three-year grant from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services that focused on culturally competent medical care for patients with SCD.
With this grant, Washington University School of Medicine has led a regional collaborative, named the Heartland Sickle Cell Disease Network, to provide education, quality improvement, and training opportunities. The Public Health Data and Training Center worked with the collaborative to track data on SCD care, providers participating in education programs, and overall monitoring of the patient population to help monitor and evaluate the program’s success.
Data Analyst Anne Trolard, MPH, presented preliminary findings from this study at the 11th annual Foundation for Sickle Cell Disease Research Symposium in Ft. Lauderdale, Florida in April.
Anne’s presentation, entitled “Geographic Disparities among Hydroxyurea (HU) Medicaid Claims from 2013-2015 in Missouri,” discussed preliminary results from the study’s two research aims: to determine the prevalence of HU prescriptions among Medicaid patients with SCD; and to identify any disparities in how these prescriptions were distributed across the state.
The study found that the majority of patients with SCD reside in the large urban areas of the state – St. Louis and Kansas City; there are also clusters near Columbia, MO and in the lower boot heel of the state, close to Memphis. Geospatial analysis revealed that while a majority of patients with SCD did not receive any prescriptions for HU from 2013-2015, there were more prescriptions observed in urban areas and fewer prescriptions in rural areas.
Additionally, the total number of prescriptions for HU increased each year, by 8% from 2013-2014, and by 37% from 2014-2015. This data reveals a need for better education on the benefits of HU to providers working in areas of the state where SCD patients reside but HU prescription rates are low or non-existent.