It is considered best practice for kids with sickle cell anemia to receive antibiotic prophylaxis to prevent serious infections. Additionally, it is recommended that they undergo transcranial Doppler (TCD) screening to determine their risk of overt stroke. However, it remains unclear how many children with sickle cell anemia actually receive antibiotic prophylaxis and/or undergo TCD screening.
To answer these questions, researchers at the University of Michigan initiated an assessment of recent rates in antibiotic prophylaxis prescription fills and TCD screening using validated quality measures. They reviewed the records of children with sickle cell anemia who were enrolled in Medicaid programs in Michigan or New York between 2011 and 2018.
Over the course of the study, the researchers assessed two outcomes within recommended age groups. The first was whether prescriptions for antibiotic prophylaxis had a filling of 300 days or more that year. The second was whether the children had undergone one or more TCD screenings that year. For each outcome, the proportion of children was calculated by state.
Ultimately, it was found that the annual rate of filling 300 days or more of antibiotics ranged from 16 to 22%. Annual rates of TCD screening ranged from 39 to 45%. These low rates were similar for both states, indicating that most children with sickle cell anemia who are enrolled in Medicaid in Michigan or New York do not receive these two recommended preventive services.
This study shows the urgent need for new, sustainable, and coordinated interventions across preventive services to ensure more children with sickle cell anemia are prescribed antibiotic prophylaxis and receive TCD screening .
Source: Reeves, S. L., Freed, G. L., Madden, B., Wu, M., Miller, L., Cogan, L., Anders, D., Creary, S. E., McCormick, J., & Dombkowski, K. J. (2021). Trends in quality of care among children with sickle cell anemia. Pediatric Blood & Cancer, 69(2). https://doi.org/10.1002/pbc.29446