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Adherence to hydroxyurea medication by children with sickle cell disease (SCD) using an electronic device: a feasibility study

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Abstract

Adherence to hydroxyurea (HU) is a significant modifying factor in sickle cell vaso-occlusive pain. We conducted a study using an electronic medication container-monitor-reminder device (GlowCap™) to track adherence and determine whether use of this device affected rates of HU adherence. Subjects were regular attendees to our clinic. They were given a 37-item questionnaire and were asked to use a GlowCap containing HU. When the device cap is opened, it makes a remote “medication taken” record. The device also provides usage reminder in the form of lights and alarm sounds if the cap opening is delayed. Nineteen subjects participated in the survey, and 17 in the intervention phase. Of the 17, 12 had reliable adherence data. Seventeen caregivers of patients and two patients completed the survey. Two most common barriers to adherence identified were lack of reminders and absence of medicine home delivery. The intervention component of this study, which used both the electronic (GlowCap) method and medication possession ratio showed that the median adherence rate for the 12 patients evaluated was 85 %. The GlowCap device accurately kept a record of adherence rates. This device may be an effective tool for increasing HU medication adherence.

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References

  1. Sparkenbaugh E, Pawlinski R. Interplay between coagulation and vascular inflammation in sickle cell disease. Br J Haematol. 2014;162:3–14.

    Article  Google Scholar 

  2. Piccin A, Murphy C, Eakins E, Kunde J, Corvetta D, DiPierro A, Negri G, Guido M, Sainati L, McMahon C, Smith OP, Murphy W. Circulating microparticles, protein C, free protein S and endothelia vascular markers in children with sickle cell anemia. J Extracell Vesicles. 2015;4:28414. doi:10.3402/ev.v4.28414.

    Article  PubMed  Google Scholar 

  3. Piccin A, Murphy C, Eakins E, Kinsella A, McMahan C, Smith OP, Murphy W. Protein C and free protein S in children with sickle cell anemia. Ann Hematol. 2012;91:1669–71.

    Article  PubMed  Google Scholar 

  4. Strouse JJ, Heeney MM. Hydroxyurea for the treatment of sickle cell disease: efficacy, barriers, toxicity, and management in children. Pediatr Blood Cancer. 2012;59:365–71.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wong TE, Brandow AM, Lim W, Lottenberg R. Update on the use of hydroxyurea therapy in sickle cell disease. Blood. 2014;124:3850–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Rees DC. The rationale for using hydroxycarbamide in the treatment of sickle cell disease. Haematologica. 2011;96:488–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Almeida CB, Souza LE, Leonardo FC, Costa FT, Werneck CC, Covas DT, Costa FF, Conran N. Acute hemolytic vascular inflammatory processes are prevented by nitric oxide replacement or a single dose of hydroxyurea. Blood. 2015;126:711–20.

    Article  CAS  PubMed  Google Scholar 

  8. Candrilli SD, O’Brien SH, Ware RE, Nahata MC, Seiber EE, Balkrishnan R. Hydroxyurea adherence and associated outcomes among Medicaid enrollees with sickle cell disease. Am J Hematol. 2011;86:273–7.

    Article  PubMed  Google Scholar 

  9. Zimmerman SA, Schultz WH, Davis JS, Pickens CV, Mortier NA, Howard TA, et al. Sustained long-term hematologic efficacy of hydroxyurea at maximum tolerated dose in children with sickle cell disease. Blood. 2004;103:2039–45.

    Article  CAS  PubMed  Google Scholar 

  10. Witherspoon D, Drotar D. Correlates of adherence to prophylactic penicillin therapy in children with sickle cell disease. Child Health Care. 2006;35:281–96.

    Article  Google Scholar 

  11. Modi AC, Crosby LF. Barriers to treatment adherence for pediatric patients with sickle cell disease and their families. Child Health Care. 2009;38:107–22.

    Article  Google Scholar 

  12. Bowen DJ, Kreuter M, Spring B, Cofta-Woerpel L, Linnan L, Weiner D, Bakken S, Kaplan CP, Squiers L, Fabrizio C, Fernandez M. How we design feasibility studies. Am J Prev Med. 2009;36:452–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Andrade SE, Kahler KH, Frech F, Chan KA. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf. 2006;15:565–74.

    Article  PubMed  Google Scholar 

  14. Elliott V, Morgan S, Day S, Mollerup LS, Wang W. Parental health beliefs and compliance with prophylactic penicillin administration in children with sickle cell disease. J Pediatr Hematol Oncol. 2001;23:112–6.

    Article  CAS  PubMed  Google Scholar 

  15. Teach SJ, Lillis KA, Grossi M. Compliance with penicillin prophylaxis in patients with sickle cell disease. Arch Pediatr Adolesc Med. 1998;152:274–8.

    Article  CAS  PubMed  Google Scholar 

  16. Berkovitch M, Papadouris D, Shaw D, Onuaha N, Dias C, Olivieri NF. Trying to improve compliance with prophylactic penicillin therapy in children with sickle cell disease. Br J Clin Pharmacol. 1998;45:605–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Davis H. Use of computerized health claims data to monitor compliance with antibiotic prophylaxis in sickle cell disease. Pharmacoepidemiol Drugs Saf. 1998;7:107–12.

    Article  CAS  Google Scholar 

  18. Bitarães EL, Oliveira BM, Viana MB. Compliance with antibiotic prophylaxis in children with sickle cell anemia: a prospective study. J Pediatr (Rio J). 2008;84:316–22.

    Article  Google Scholar 

  19. Patel NG, Lindsey T, Strunk RC, DeBaun MR. Prevalence of daily medication adherence among children with sickle cell disease: a 1-year retrospective cohort analysis. Pediatr Blood Cancer. 2010;55:554–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Thornburg CD, Calatroni A, Telen M, Kemper AR. Adherence to hydroxyurea therapy in children with sickle cell anemia. J Pediatr. 2010;156:415–9.

    Article  CAS  PubMed  Google Scholar 

  21. Crosby LE, Modi AC, Lemanek KL, Guilfoyle SM, Kalinyak KA, Mitchell MJ. Perceived barriers to clinic appointments for adolescents with sickle cell disease. J Pediatr Hematol Oncol. 2009;31:571–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Olivieri NF, Vichinsky EP. Hydroxyurea in children with sickle cell disease: impact on splenic function and compliance with therapy. J Pediatr Hematol Oncol. 1998;20:26–31.

    Article  CAS  PubMed  Google Scholar 

  23. Kinney TR, Helms RW, O’Branski EE, Ohene-Frempong K, Wang W, Daeschner C, Pediatric Hydroxyurea Group, et al. Safety of hydroxyurea in children with sickle cell anemia: results of the HUG-KIDS study, a phase I/II trial. Blood. 1999;94:1550–4.

    CAS  PubMed  Google Scholar 

  24. Estepp JH, Winter B, Johnson M, Smeltzer MP, Howard SC, Hankins JS. Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia. Pediatr Blood Cancer. 2014;61:2031–6.

    Article  CAS  PubMed  Google Scholar 

  25. Creary SE, Gladwin MT, Byrne M, Hildesheim M, Krishnamurti L. A pilot study of electronic directly observed therapy to improve hydroxyurea adherence in pediatric patients with sickle-cell disease. Pediatr Blood Cancer. 2014;61:1068–73.

    Article  CAS  PubMed  Google Scholar 

  26. Inui TS, Carter WB, Pecoraro RE. Screening for noncompliance among patients with hypertension: is self-report the best available measure? Med Care. 1981;19:1061–4.

    Article  CAS  PubMed  Google Scholar 

  27. Inui TS, Carter WB, Pecoraro RE. Variations in patient compliance with common long-term drugs. Med Care. 1980;18:986–93.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Authors thank Dr. Kay Taylor for reviewing this manuscript and giving us helpful editorial advice, and Stephen Lott, PhD for collecting and organizing data. Authors are indebted to Nila Carpenter, RN for her efforts in giving orientations and instructions regarding the GlowCap to patients and caregivers. We thank Dean David Gordon for kind assistance in grant writing.

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Authors and Affiliations

  1. Hurley Children’s Hospital and Department of Pediatrics/Human Development, Michigan State University, College of Human Medicine, Flint, MI, 48503, USA

    Susumu Inoue, Tammy Scherrer & Nkechi Onwuzurike

  2. Department of Public Health, School of Health Sciences, University of Michigan-Flint, Flint, MI, USA

    Gergana Kodjebacheva & Jeremy Blankenship

  3. Diplomat Specialty Pharmacy, Flint, MI, USA

    Gary Rice & Matthew Grigorian

Authors
  1. Susumu Inoue
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  2. Gergana Kodjebacheva
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  3. Tammy Scherrer
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  4. Gary Rice
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  5. Matthew Grigorian
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  6. Jeremy Blankenship
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  7. Nkechi Onwuzurike
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Corresponding author

Correspondence to Susumu Inoue.

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Funding

This study was supported by an in-kind research grant from the Community Foundation of Greater Flint (a non-profit organization) and Diplomat Pharmacy that supplied GlowCap™.

Conflict of interest

None of the authors have financial interests in the VITALITY Company. There has not been any financial relationship between Diplomat Pharmacy and Hurley Medical Center, or between Diplomat Pharmacy and the VITALITY Company. One of the authors, GR is an employee of the Diplomat Pharmacy, but Diplomat Pharmacy received no financial incentives from the VITALITY Company. All authors declare no conflict of interests.

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Inoue, S., Kodjebacheva, G., Scherrer, T. et al. Adherence to hydroxyurea medication by children with sickle cell disease (SCD) using an electronic device: a feasibility study. Int J Hematol 104, 200–207 (2016). https://doi.org/10.1007/s12185-016-2027-x

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  • DOI: https://doi.org/10.1007/s12185-016-2027-x

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