Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 1;153(4):e2022060804.
doi: 10.1542/peds.2022-060804.

National Quality Indicators in Pediatric Sickle Cell Anemia

Ashaunta T Anderson  1   2 , Wendy J Mack  1 , Sophia S Horiuchi  3 , Susan Paulukonis  3 , Mei Zhou  4 , Angela B Snyder  4 , Jason N Doctor  5 , Michele Kipke  1   2 , Thomas Coates  1   2 , Gary Freed  6
Affiliations

National Quality Indicators in Pediatric Sickle Cell Anemia

Ashaunta T Anderson et al. Pediatrics. .

Abstract

Objective: To assess nationally endorsed claims-based quality measures in pediatric sickle cell anemia (SCA).

Methods: Using data from the Sickle Cell Data Collection programs in California and Georgia from 2010 to 2019, we evaluated 2 quality measures in individuals with hemoglobin S/S or S/β-zero thalassemia: (1) the proportion of patients aged 3 months to 5 years who were dispensed antibiotic prophylaxis for at least 300 days within each measurement year and (2) the proportion of patients aged 2 to 15 years who received at least 1 transcranial Doppler ultrasound (TCD) within each measurement year. We then evaluated differences by year and tested whether performance on quality measures differed according to demographic and clinical factors.

Results: Only 22.2% of those in California and 15.5% in Georgia met or exceeded the quality measure for antibiotic prophylaxis, with increased odds associated with rural residence in Georgia (odds ratio 1.61; 95% confidence interval 1.21-2.14) compared with urban residence and a trend toward increased odds associated with a pediatric hematologist prescriber (odds ratio 1.28; 95% confidence interval 0.97, 1.69) compared with a general pediatrician. Approximately one-half of the sample received an annual assessment of stroke risk using TCD (47.4% in California and 52.7% in Georgia), with increased odds each additional year in both states and among younger children.

Conclusions: The rates of receipt of recommended antibiotic prophylaxis and annual TCD were low in this sample of children with SCA. These evidence-based quality measures can be tracked over time to help identify policies and practices that maximize survival in SCA.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no potential conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Antibiotic prophylaxis. Percentage of children aged 3 months to 4 years old with SCA who were dispensed appropriate antibiotic prophylaxis for at least 300 days within each measurement year.
FIGURE 2
FIGURE 2
TCD screening. Percentage of children aged 2 to 15 years old with SCA who received at least 1 TCD screening within each measurement year.
See this image and copyright information in PMC

Comment in

References

    1. Brousseau DC, Panepinto JA, Nimmer M, Hoffmann RG. The number of people with sickle-cell disease in the United States: national and state estimates. Am J Hematol. 2010;85(1):77–78 - PubMed
    1. National Human Genome Research Institute. Learning about sickle cell disease. Available at: https://www.genome.gov/10001219. Accessed November 17, 2022
    1. Lanzkron S, Carroll CP, Haywood CJr. Mortality rates and age at death from sickle cell disease: U.S., 1979–2005. Public Health Rep. 2013;128(2):110–116 - PMC - PubMed
    1. Hamideh D, Alvarez O. Sickle cell disease related mortality in the United States (1999-2009). Pediatr Blood Cancer. 2013;60(9):1482–1486 - PubMed
    1. Quinn CT, Rogers ZR, Buchanan GR. Survival of children with sickle cell disease. Blood. 2004;103(11):4023–4027 - PMC - PubMed