HABIT efficacy and sustainability trial, a multi-center randomized controlled trial to improve hydroxyurea adherence in youth with sickle cell disease: a study protocol

被引:11
作者
Smaldone, Arlene [1 ,2 ]
Manwani, Deepa [3 ]
Aygun, Banu [4 ]
Smith-Whitley, Kim [5 ]
Jia, Haomiao [1 ,6 ]
Bruzzese, Jean-Marie [1 ]
Findley, Sally [6 ]
Massei, Joshua [1 ]
Green, Nancy S. [7 ]
机构
[1] Columbia Univ, Sch Nursing, New York, NY 10027 USA
[2] Columbia Univ, Coll Dent Med, New York, NY 10027 USA
[3] Albert Einstein Coll Med, Bronx, NY 10467 USA
[4] Zucker Sch Med Hofstra Northwell, New Hyde Pk, NY USA
[5] Perelman Sch Med, Philadelphia, PA USA
[6] Mailman Sch Publ Hlth, New York, NY USA
[7] Columbia Univ, Vagelos Coll Phys & Surg, New York, NY USA
基金
美国国家卫生研究院;
关键词
Sickle cell disease; Hydroxyurea; Community health workers; Mobile health; Randomized controlled trial; Adherence; Health related quality of life; COMMUNITY-HEALTH WORKERS; QUALITY-OF-LIFE; MEDICATION ADHERENCE; FETAL-HEMOGLOBIN; GLYCEMIC CONTROL; SELF-MANAGEMENT; FAMILY RESPONSIBILITY; DIABETES MANAGEMENT; PEDIATRIC-PATIENTS; CARE UTILIZATION;
D O I
10.1186/s12887-019-1746-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Hydroxyurea (HU) is recommended as standard practice for youth with sickle cell disease (SCD). Yet, despite its efficacy, HU adherence in adolescents and young adults is often poor. Poor medication adherence increases disease burden, healthcare cost and widens health disparities. Adolescence is a critical time to improve adherence through improved chronic disease self-management. This study aims to test the efficacy of an intervention delivered to youth/parent dyads by community health workers (CHWs), augmented by tailored text messages on HU adherence (primary outcome). Secondary outcomes are intervention sustainability, youth health-related quality of life, self-management responsibility concordance, acute hospital use and self-reported disease symptoms. Methods Hydroxyurea Adherence for Personal Best in Sickle Cell Disease, "HABIT," is a 12 month multi-center randomized controlled trial. One hundred four youth, 10 to 18 years of age prescribed HU who meet eligibility criteria, enrolled with their parent as dyads, will be randomized 1:1 to either the HABIT intervention or to usual clinical care plus education handouts. All subjects will complete clinic visits at months 0, 2, 4, 6 (efficacy component), 9 and 12 (sustainability component) for assessment of HbF biomarker, other hematologic parameters, and to complete questionnaires. In addition, dyads assigned to the HABIT intervention will work with CHWs to identify a daily habit (e.g., brushing teeth) on which to build a HU adherence habit. Tailored daily text message reminders to support the habit will be developed by the dyad in collaboration with the CHWs and sent to parent and youth. At the 6 month visit, the intervention will end and the sustainability portion of the trial will begin. All data analyses will be based on intention to treat with all randomized subjects included in the analyses. Discussion Prior retrospective studies demonstrate that a majority of adolescents are poorly adherent to HU. If efficacious, the HABIT intervention has the potential to improve the lives of youth with SCD.
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页数:12
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