Session: 901. Health Services and Quality Improvement - Non-Malignant Conditions: Poster III
Hematology Disease Topics & Pathways:
Clinical Practice (Health Services and Quality), Clinical Research, Therapies
Methods: SCD providers were recruited from across the United States using maximum variation purposeful sampling to ensure diversity in provider characteristics (age, sex, race, discipline, years in profession) and clinics (region, patient volume). After electronic consent, providers completed a demographics survey and joined a private online “crowd” on Slack. There were five waves of data collection; during each wave, a series of 4-5 questions were posed to the crowd. Providers were paid for each question they answered and encouraged to view and respond to others’ posts. Thematic content analysis was used to summarize perspectives on resources needed to help healthcare providers better engage patients and caregivers in SDM for sickle cell therapies. Two raters independently coded each provider’s responses; coding discrepancies were resolved via group discussion to consensus.
Results: Of the 59 SCD providers who enrolled, approximately two-thirds were female (67%) and 61% were White; the remainder of the sample identified as Asian (20%), Black or African American (10%), or Middle Eastern (3%). Most were non-Hispanic or Latino (95%). Providers included physicians (73%), nurse practitioners or advanced practice nurses (22%), and nurses (5%) with a wide range of years in practice (2 – 57, M=12.8, SD=10.6). Providers were employed at care centers serving pediatric patients (37%), adult patients (29%), or both pediatric and adult patients with SCD (34%), with annual patient volume ranging from 16 to 2200 (M=420.5, SD=405.1). Across the waves of data collection, response rates ranged from 53-59%.
These clinicians identified five resources necessary to optimize SDM for disease-modifying therapies: 1) well-staffed multidisciplinary care teams; 2) high quality patient education materials; 3) billing and reimbursement policies that incentivize SDM; 4) resources to address social determinants of health barriers; and, 5) peer mentoring and support programs for patients. See Table 1 for illustrative quotes.
Conclusions: Providers identified several supports and resources to facilitate SDM with individuals with SCD. Findings from this study will inform the development of a multi-component SDM intervention, including decision support tools for patients, caregivers, and healthcare providers and clinic-based implementation tools.
Acknowledgements: This research was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number P20GM109021. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Disclosures: No relevant conflicts of interest to declare.
See more of: Oral and Poster Abstracts