Embedding a primary care provider in sickle cell teams improves sickle cell care

Area of Science:

• Internal Medicine
• Hematology
• Public Health

Background:

• Adults with sickle cell disease (SCD) often face challenges accessing primary and preventive care.
• This fragmented care leads to suboptimal adherence to general and SCD-specific clinical guidelines.

Purpose of the Study:

• To evaluate the impact of embedding a primary care provider (PCP) within an adult SCD care team.
• To determine if this integrated model improves guideline-based preventive care and affects acute healthcare utilization.

Main Methods:

• A retrospective cohort study was conducted on 388 adults with SCD at a tertiary care center (July 2020 - June 2025).
• 174 patients received care from an embedded PCP practicing alongside hematologists.
• Adherence to preventive care guidelines and healthcare utilization were compared between groups.

Main Results:

• Patients receiving care from the embedded PCP showed significantly higher adherence to general preventive care (e.g., cervical cancer screening, depression screening, Tdap immunization) and SCD-specific guidelines (e.g., annual eye exams, pneumococcal immunization, urine protein screening, ACE inhibitor/ARB use).
• The embedded PCP model was associated with a significant increase in annual outpatient visits (4.2 vs. 2.7) and a non-significant decrease in annual inpatient admissions (1.4 vs. 1.9).

Conclusions:

• Embedding a PCP into adult SCD care teams significantly improves adherence to preventive care guidelines.
• This integrated model promotes more coordinated, outpatient-focused management, leading to increased outpatient visits for patients with SCD.