# Implementation of Medical Homes for Evidence Based Care of Adolescents and Adults with Sickle Cell Disease

> **NIH NIH U01** · AUGUSTA UNIVERSITY · 2020 · $27,519

## Abstract

Problem. Suboptimal adherence to medications and treatment is associated with increased
morbidity and mortality, with associated health care costs estimated between 100 - 300 billion
dollars, nationally. Adherence to hydroxyurea (HU) is a problem for persons with sickle cell
disease (SCD). A landmark double-blind randomized, controlled trial demonstrated the benefits
of HU use by adult patients with SCD. Participants taking HU experienced a reduction in the
frequency of vaso-occlusive crises, hospitalizations, and the need for blood transfusions. HU is
a fetal hemoglobin (HbF) inducer that mitigates many of the chronic complications in persons
with SCD and is the principle U.S. FDA approved medication for adults (1998) and children
(2017) with SCD. HU also reduces the episodes of acute chest syndrome, number of
hospitalizations, and mortality.
Known. Poor adherence to HU is associated with lower fetal hemoglobin and the protective
factors associated with the treatment. Adherence strategies include treatment simplification and
decreased dosing (1 or 2 times per day), behavioral interventions given 1 to 1, and linking
adherence to routine habits.
Proposed Solution. The Hydroxyurea Adherence Project (HAP) is a behavioral pilot
intervention study. It can be summarized as a project using a set of behavioral intervention
strategies to improve adherence to hydroxyurea (HU) and health outcomes in persons with
sickle cell disease. This project is based on the findings from HU adherence literature to
determine strategies that may promote HU adherence.
The Parent Grant title: Implementation of medical homes for evidence-based care of
adolescents and adults with sickle cell disease. The parent grant authors identified
substantial study evidence that supports the benefit of HU. Currently, acceptance of HU is
inadequate, given the considerable disease burden and early mortality associated
nonadherence. Strategies to increase adoption of the SCD clinical practice guidelines13
including HU use within a Patient-Centered Medical Neighborhood model is an important goal.
HU adherence can change the course of disease progression in persons with sickle cell disease
and thus result in a healthier life. The goal of this project is to improve adherence to HU therapy
by empowering the person with SCD in behavior change that supports adherence to
hydroxyurea for the person’s health benefit.

## Key facts

- **NIH application ID:** 10005740
- **Project number:** 3U01HL134004-04S2
- **Recipient organization:** AUGUSTA UNIVERSITY
- **Principal Investigator:** Robert William Gibson
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $27,519
- **Award type:** 3
- **Project period:** 2016-08-05 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005740

## Citation

> US National Institutes of Health, RePORTER application 10005740, Implementation of Medical Homes for Evidence Based Care of Adolescents and Adults with Sickle Cell Disease (3U01HL134004-04S2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10005740. Licensed CC0.

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