Health
These sisters with sickle cell disease suffered a catastrophic and preventable stroke
Dr. Julie Canter, a hematologist at the University of Alabama at Birmingham and director of the University’s Adult Sickle Cell Clinic, said she has 5,347 children in 28 large and small medical centers, including academic and small medical centers. Stated. I checked the medical record. At some centers, only 30-75 percent of children received the recommended screening. On average, only 48.4 percent obtained ultrasound. Fees were independent of the size of the medical center and the discipline to which it belonged.
“The rate is terrible, actually worse than we thought,” Dr. Canter said.
Researchers investigated parents and caregivers and found that some doctors did not tell their parents about screening. Some parents, even if told, did not understand their crucial importance. (Dr. Canter wants to change the name of the test to “stroke screen” instead of transcranial Doppler ultrasound, which makes the purpose clear.) Part with a special sickle erythrocyte clinic The medical center was unable to consistently follow up on families who missed an appointment.
There was also a logistics failure. From time to time, medical centers offering tests were far from homes for sick children. Some parents had a hard time taking a break from work to take their children to the exam. And the centers we tested were sometimes outside the family insurance network.
Ultrasonography is not the only medical requirement that has not been consistently given to children with sickle cell disease. Hydroxyurea, an inexpensive generic drug, has been able to reduce the risk of irreversible damage to organs and the brain since the 1980s. But it’s badly underutilized. Guidelines from the National Institutes of Health As announced in 2014, all children and adolescents, and adults suffering from a pain crisis or other serious complications, should take at least 3 times a year.
A Recent survey It was found that only 48 percent of the 2,200 sickle cell patients from eight sites funded by the National Institutes of Health take hydroxyurea on a regular basis. Interviews with doctors who did not prescribe the drug revealed that many were unfamiliar with the drug and others were afraid of hydroxyurea. Hydroxyurea is also a much higher dose of cancer treatment and can cause cancer with lower doses of sickle cells.
Another recent study, Of the 2,790 Medicaid patients with sickle cell disease in North Carolina, only 32% were prescribed hydroxyurea, and only 31% of these patients were taking the drug on a regular basis. was there.
These sisters with sickle cell disease suffered a catastrophic and preventable stroke
Source link These sisters with sickle cell disease suffered a catastrophic and preventable stroke
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