{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:14:23Z","timestamp":1790813663043,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although new pharmaceutical therapy options have recently become available, hydroxyurea is still the most commonly used and affordable treatment option for sickle cell disease (SCD). This study aimed to update the evidence on hydroxyurea adherence and its association with clinical and economic outcomes among individuals with SCD. This retrospective study used Texas Medicaid claims data from 09\/2011\u201308\/2016. Individuals were included if they had \u22651 inpatient or \u22652 outpatient SCD diagnoses, had \u22651 hydroxyurea prescription, were 2\u201363\u2009years of age, and were continuously enrolled in Texas Medicaid between 6\u2009months before and 1\u2009year after the first hydroxyurea prescription fill date (index date). Hydroxyurea adherence (Medication Possession Ratio; MPR), vaso\u2010occlusive crisis (VOC)\u2010related outcomes, healthcare utilization and expenditures (SCD\u2010related and all\u2010cause) during the 1\u2009year following the index date were measured. Bivariate and multivariable analyses were used to address the study objectives. Among 1035 included individuals (age: 18.8\u2009\u00b1\u200912.5\u2009years, female: 52.1%), 20.9% were adherent to hydroxyurea (defined as MPR\u22650.8). After adjustment for demographic and clinical characteristics, compared to being non\u2010adherent, adhering to hydroxyurea was significantly associated with: a lower risk (Odds Ratio [OR]\u00a0=\u00a00.480, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0007) and hazard rate (Hazard Ratio [HR]\u00a0=\u00a00.748, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0005) of a VOC event, fewer VOC events (Incidence Rate Ratio [IRR]\u00a0=\u00a00.767, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0009), fewer VOC\u2010related hospital days (IRR\u00a0=\u00a00.593, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0003), fewer all\u2010cause and SCD\u2010related hospitalizations (IRR\u00a0=\u00a00.712, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0008; IRR\u00a0=\u00a00.707, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0008, respectively) and emergency department visits (IRR\u00a0=\u00a00.768, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0037; IRR\u00a0=\u00a00.746, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0041, respectively), and lower SCD\u2010related total healthcare expenditures (IRR\u00a0=\u00a00.796, <jats:italic>p<\/jats:italic>\u00a0=\u2009.0266). Efforts to increase adherence to hydroxyurea could improve clinical and economic outcomes among individuals with SCD.<\/jats:p>","DOI":"10.1002\/ajh.26765","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T16:00:27Z","timestamp":1666022427000},"page":"90-101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of adherence to hydroxyurea on health outcomes among patients with sickle cell disease"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-742X","authenticated-orcid":false,"given":"Hyeun Ah","family":"Kang","sequence":"first","affiliation":[{"name":"College of Pharmacy The University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6078-8093","authenticated-orcid":false,"given":"Jamie C.","family":"Barner","sequence":"additional","affiliation":[{"name":"College of Pharmacy The University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8520-8422","authenticated-orcid":false,"given":"Kenneth A.","family":"Lawson","sequence":"additional","affiliation":[{"name":"College of Pharmacy The University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9907-7670","authenticated-orcid":false,"given":"Karen","family":"Rascati","sequence":"additional","affiliation":[{"name":"College of Pharmacy The University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Mignacca","sequence":"additional","affiliation":[{"name":"Dell Medical School The University of Texas at Austin  Austin Texas USA"},{"name":"Children's Blood and Cancer Center at Dell Children's Hospital  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Sickle Cell Disease","author":"Centers for Disease Control and Prevention (2002)"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.022"},{"key":"e_1_2_9_4_1","first-page":"1685","volume-title":"Pharmacotherapy: A Pathophysiologic Approach","author":"Chan CYJ","year":"2008"},{"key":"e_1_2_9_5_1","volume-title":"The Management of Sickle Cell Disease","author":"Bethesda M","year":"2002"},{"key":"e_1_2_9_6_1","volume-title":"Fifty\u2010Ninth World Health Assembly, Geneva, 22\u201327 May 2006: Resolutions and Decisions: Annexes","author":"World Health Assembly","year":"2006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20336"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-04-383430"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-498311"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200220060-00001"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21807"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21443"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.36469\/jheor.2020.13348"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006223422502"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90136-8"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04594.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/03630269.2011.610478"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505183322001"},{"issue":"5","key":"e_1_2_9_19_1","first-page":"1550","article-title":"Safety of hydroxyurea in children with sickle cell anemia: results of the HUG\u2010KIDS study, a phase I\/II trial","volume":"94","author":"Kinney TR","year":"1999","journal-title":"Blood"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.119590"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.13.1645"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20142"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-12-4973"},{"key":"e_1_2_9_24_1","unstructured":"U.S. Food and Drug Administration (FDA).ENDARI (L\u2010glutamine) Prescribing Information. 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