{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:26:29Z","timestamp":1790400389731,"version":"4.1.0"},"reference-count":71,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R18 HL112737"],"award-info":[{"award-number":["R18 HL112737"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Hydroxyurea (hydroxycarbamide) (HU) for sickle cell anaemia (SCA) is underutilised. Case management is an evidence\u2010based health management strategy and in this regard patient navigators (PNs) may provide case management for SCA. We hypothesised that HU\u2010eligible patients exposed to PNs would have improved indicators of starting HU and HU adherence. We randomised 224 HU\u2010eligible SCA adults into the Start Healing in Patients with Hydroxyurea (SHIP\u2010HU) Trial. All patients received care from trained physicians using standardised HU prescribing protocols. Patients in the Experimental arm received case management and education from PNs through multiple contacts. All other patients were regarded as the Control arm and received specialty care alone. Study physicians were blinded to the study arms and did not interact with PNs. At baseline, 6 and 12\u2009months we assessed and compared laboratory parameters and HU adherence indicators. Experimental patients had higher 6\u2010month mean fetal haemoglobin (HbF) levels than controls. But at 12\u2009months, mean HbF was similar, as were white blood cell count, absolute neutrophil count, total haemoglobin, platelet count and mean corpuscular volume. At 12 months there were fewer experimental patients missing HU doses than controls (mean 1\u00b78 vs. 4\u00b75, <jats:italic>P\u2009<\/jats:italic>=\u20090\u00b70098), and more recent HU prescriptions filled than for controls (mean 53\u00b78 vs. 92\u2009days, median 27\u00b75 vs. 62\u2009days, <jats:italic>P<\/jats:italic>\u2009=\u20090\u00b70082). Mean HU doses were largely similar. We detected behavioural improvements in HU adherence but no haematological improvements by adding PNs to specialty care.<\/jats:p>","DOI":"10.1111\/bjh.17952","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T01:03:02Z","timestamp":1637110982000},"page":"193-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A randomised controlled provider\u2010blinded trial of community health workers in sickle cell anaemia: effects on haematologic variables and hydroxyurea adherence"],"prefix":"10.1111","volume":"196","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4122-5367","authenticated-orcid":false,"given":"Wally R.","family":"Smith","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine Virginia Commonwealth University  Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna K.","family":"McClish","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Virginia Commonwealth University  Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lottenberg","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology Department of Medicine University of Florida College of Medicine  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"India Y.","family":"Sisler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Haematology and Oncology Children\u2019s Hospital of Richmond at Virginia Commonwealth University  Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Sop","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine Virginia Commonwealth University  Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Johnson","sequence":"additional","affiliation":[{"name":"Adult Sickle Cell Program Division of General Internal Medicine Virginia Commonwealth University  Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Villella","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Haematology &amp; Oncology  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1480-7887","authenticated-orcid":false,"given":"Darla","family":"Liles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Brody School of Medicine at East Carolina University  Greenville NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Yang","sequence":"additional","affiliation":[{"name":"Pediatric Specialists of Virginia 6565 Arlington Boulevard  Falls Church VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Chen","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School Medical Service Hampton VA Medical Center  Hampton VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Best Care at Lower Cost: The Path to Continuously Learning Health Care in America","author":"IOM (Institute of Medicine)","year":"2013"},{"key":"e_1_2_12_3_1","volume-title":"Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century","author":"Institute of Medicine","year":"2003"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEH.0000000000000274"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145721710371524"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181e35b51"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-009-9206-0"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1434-6"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.0.0124"},{"key":"e_1_2_12_10_1","unstructured":"PittmanM SunderlandA BroderickA BarnettK.Bringing community health workers into the mainstream of U.S. health care. 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