Laboratory and clinical outcomes by clinic location
We identified no significant differences in HU monitoring laboratory
values for Hb (p=0.6), MCV (p=0.7), HbF (p=0.13), ANC (p=0.9) by clinic
location (Table 2). We did not identify a difference in all admissions
to the hospital (p=0.5) or pain admissions to the hospital (p=0.6)
between academic center vs. satellite clinic patients. However, academic
center patients did have a higher number of acute pain visits (p=0.03)
to either the ED or UAB pediatric pain clinic (Table 3). As expected,
among all participants, non-adherence to HU (HbF <5%) was
associated with the highest number of admissions (p=0.02). Among 149
patients with more than one clinic visit, 97 (65%) patients had more
than 65% of clinic visits with a correct dose adjustment; we identified
no statistical difference in correct dosing adjustment among Birmingham
patients (67%) and satellite clinic patients (62%, p=0.5). Patients
cared for at the academic center had a statistically higher number of
clinic visits (p=0.01) and more patients that attended >2
clinic visits. HbF response was significantly associated with the number
of clinic visits (p=0.03). Finally, HbF response was significantly
inversely correlated with age (p=0.003). Adjusting for clinic location,
number of clinic visits, and age, HbF was associated with age (p=0.006)
and clinic visits (p=0.006), but not associated with clinic location.