Palliative care can help decrease symptoms and improve the quality of care of patients with sickle cell disease, especially those who are hospitalized. However, the use of palliative care can vary across different populations of hospitalized patients with sickle cell disease.
Sickle cell disease (SCD) is a serious, inherited blood disorder characterized by chronic complications, including acute pain episodes, organ damage, and anemia. Due to the array of complications linked to SCD, palliative care is a vital aspect of SCD treatment.
Patients with SCD are often hospitalized for vaso-occlusive crises and end-organ damage, with most SCD patients dying in the hospital (63%) or emergency room (15%). Despite the availability of palliative care treatments to improve patient quality of life, little data is available to illustrate the use of palliative care services in adult patients with SCD.
Researchers analyzed data from 2008 to 2017 from the National Inpatient Sample (NIS) database, which contains data from around 35 million hospitalizations across 47 states and the District of Columbia. The retrospective cross-sectional study evaluated hospitalizations in patients over 18 years old with a diagnosis of SCD. The primary outcome measure was palliative care service use.
Out of 987,555 SCD-related hospitalizations, only 4,442 hospitalizations involved the use of palliative care services. Black and Hispanic patients were 33% and 35% less likely to receive palliative care services than White patients. In addition, female patients, Medicaid patients, and patients hospitalized in rural or urban non-teaching hospital settings had a low probability of receiving palliative care.
There is a need for improved access to palliative care, especially as less than 1% of patients hospitalized with SCD may be receiving palliative care. Certain groups of patients who could benefit from palliative care services, including Black, Hispanic, female, and Medicaid patients, may be facing barriers to palliative care. Healthcare providers could improve their treatment plans by utilizing palliative treatments to improve the quality of life of patients with SCD.
Nwogu-Onyemkpa, E., Dongarwar, D., Salihu, H. M., Akpati, L., Marroquin, M., Abadom, M., & Naik, A. D. (2022). Inpatient palliative care use by patients with sickle cell disease: a retrospective cross-sectional study. BMJ Open, 12(8), e057361. https://doi.org/10.1136/bmjopen-2021-057361