# RE-aiming at Hydroxyurea Adherence for Sickle cell with mHealth (RE-HASH)

> **NIH NIH U01** · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · 2021 · $638,420

## Abstract

PROJECT SUMMARY
Hydroxyurea is a once-a-day oral medication that reduces hospitalizations, transfusions, and medical care
costs among patients with sickle cell disease (SCD). Despite these positive benefits, hydroxyurea is not widely
used, which reduces the clinical benefits of the drug. The main factors include misperceptions by patients and
providers regarding the risks and benefits of hydroxyurea and patients’difficulty in remembering to take the
medication. Our long-term goal is to foster increased use of hydroxyurea among patients with SCD through the
use of mobile technology. Our initial approach in Aim 1 is to fully understand all factors influencing the initiation
or continuation of hydroxyurea therapy by patients, families, and providers. For this, we will interview patients,
families, providers, and analyze Medicaid, Medicare, and commercial payer data. We will link the data from the
medical system (payer data), with that of individuals, families, and providers. We will identify the reasons
hydroxyurea is started and continued. Next, in Aim 2, we will develop and test a new cellular phone text
messaging application that will help patients stay on hydroxyurea. We will seek input from patients inquiring
about their preferences and perceptions of useful features of a new text messaging application. We will then
test this new text messaging application in a group of adolescents and adults in Memphis. We will pay
particular attention to how providers and patients see the importance of this intervention and how well it works
to improve the effect of HU treatment, such as, improvement of laboratory measures, quality of life. We will
then further improve the application based on these initial results. Lastly, in Aim 3, we will expand the testing of
this new text messaging application in a large randomized study of patients in different geographical areas of
the country. We will study how well it is adopted by patients and providers, how much it changed the patients’
perception regarding the difficulties in taking their medication, its costs, and how well it worked to increase HU
clinical benefits. Throughout our study, we will use the RE-AIM (Reach, Effectiveness, Adoption,
Implementation, and Maintenance) implementation science model to help us measure the large-scale impact of
text messaging in the treatment of patients with SCD with hydroxyurea. Ultimately, it is the goal of this project
to provide evidence for an effective, low cost, and accessible mobile health technology (cellular phone text
messaging) that will lead to better usage of hydroxyurea and improvement of overall health outcomes of
individuals living with SCD.

## Key facts

- **NIH application ID:** 10197192
- **Project number:** 5U01HL133996-06
- **Recipient organization:** ST. JUDE CHILDREN'S RESEARCH HOSPITAL
- **Principal Investigator:** Jane Silva Hankins
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $638,420
- **Award type:** 5
- **Project period:** 2016-08-08 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10197192

## Citation

> US National Institutes of Health, RePORTER application 10197192, RE-aiming at Hydroxyurea Adherence for Sickle cell with mHealth (RE-HASH) (5U01HL133996-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10197192. Licensed CC0.

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