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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

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A transition pilot program for adolescents with sickle cell disease.

Jane S Hankins¹, Raymond Osarogiagbon, Patricia Adams-Graves

¹Department of Hematology, St Jude Children’s Research Hospital, Memphis, TN 38105, USA. jane.hankins@stjude.org

Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners

|July 24, 2012

Summary

This pilot program successfully helped adolescents with sickle cell disease (SCD) transition to adult care, with most participants establishing an adult medical home. The program proved feasible and improved appointment completion rates.

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Area of Science:

Pediatric Hematology
Transition of Care
Chronic Illness Management

Background:

Transitioning from pediatric to adult healthcare is a critical challenge for adolescents with chronic conditions like sickle cell disease (SCD).
A pilot program was developed to aid adolescents with SCD in identifying and connecting with an adult medical home.
This initiative aims to bridge the gap in care continuity for young adults with SCD.

Purpose of the Study:

To evaluate the feasibility, participation, satisfaction, and acceptance of a pilot transition program for adolescents with SCD.
To compare the rate of first adult hematology appointments between program participants and nonparticipants.
To assess the overall impact of the program on establishing adult medical care for SCD patients.

Main Methods:

The study involved inviting 83 adolescents with SCD to participate in the transition program.
Data collected included participation rates, patient satisfaction, and appointment completion.
A comparative analysis was performed between participants and nonparticipants regarding their engagement with adult hematology services.

Main Results:

Out of 83 invited adolescents, 34 (41%) participated, with 25 (74%) completing their first adult visit within 3 months post-transition.
Participants were significantly more likely to complete their first adult hematology appointment compared to nonparticipants (74% vs. 33%, p = .0002).
Overall, 49% of adolescents in the program completed an adult SCD appointment, a substantial increase from 15% before the program's implementation (p < .0001).

Conclusions:

The pilot transition program is a feasible and effective model for supporting adolescents with SCD.
The program significantly increased the likelihood of adolescents establishing care with an adult medical home.
Successful transition to adult care is achievable with targeted support programs for chronic conditions like SCD.