{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:17:05Z","timestamp":1787836625920,"version":"build-2784847793"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hydroxyurea, first-line therapy in sickle cell disease (SCD), has suboptimal adherence ranging from 10%-36%. Thus, examining longitudinal adherence trajectories may help identify critical timepoints and individual subgroups for targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify distinct longitudinal hydroxyurea adherence trajectories among individuals with SCD enrolled in Texas Medicaid and to examine sociodemographic and clinical factors associated with trajectory group membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective, longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of Texas Medicaid data (01\/01\/2016-08\/31\/2023) included individuals with \u22653 medical claims for SCD, \u22651 prescription claim for hydroxyurea without a claim in the pre-index period, aged 2-63 years on the index date (first hydroxyurea claim), and continuously enrolled in Texas Medicaid for 6 months pre- and 12 months post-index. Proportion of days covered (PDC) was used to estimate adherence. Group-based trajectory modeling (GBTM) was used to identify hydroxyurea adherence trajectories. Multinomial logistic regression was used to examine factors associated with hydroxyurea adherence trajectory group membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of included individuals (N=1,246; mean age=18.1\u00b112.7, 50.8% female), GBTM revealed five membership groups: consistent adherence (16.1%; mean PDC=89.2\u00b18.5%), fluctuating adherence (28.7%; mean PDC=52.6\u00b112.8), sharp decline and fluctuating adherence (16.5%; mean PDC=26.2\u00b18.8), rapidly decreasing adherence (22.2%; mean PDC=25.6\u00b110.3), and early and consistent nonadherence (16.5%; mean PDC=8.4\u00b11.3). Potential intervention timepoints were identified at months 2, 3, and 5, when adherence declined markedly. Age groups 16-21, 22-34, and \u226535 years (reference: 2-15 years), and an increasing number of vaso-occlusive crises (VOC) in the pre-index period were significantly associated with higher odds of being in the less-adherent trajectory groups compared to the consistent adherence trajectory group: adjusted odds ratio (aORs) range: age groups=2.2-8.7; VOC=1.2-1.4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Unique adherence trajectory patterns with critical timepoints for intervention were observed. Individualized and timely interventions should be tailored to adults, especially those who are transitioning to adult care (22-34 years), and those experiencing frequent VOC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406207261481884","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:26:22Z","timestamp":1787563582000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with longitudinal hydroxyurea adherence trajectories among individuals with sickle cell disease in Texas Medicaid: A group-based trajectory modeling study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6177-0477","authenticated-orcid":false,"given":"Blessing I.","family":"Okoye","sequence":"first","affiliation":[{"name":"The University of Texas at Austin,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godwin","family":"Okoye","sequence":"additional","affiliation":[{"name":"The University of Texas at Austin,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie C.","family":"Barner","sequence":"additional","affiliation":[{"name":"The University of Texas at Austin,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10233"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.022"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2023-177988"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8296139"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2026.32.7.832"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2026.2634988"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-023-02545-7"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021006281"},{"key":"e_1_3_8_10_2","volume-title":"Evidence-based management of sickle cell disease: Expert panel report","author":"National Heart, Lung, and Blood Institute","year":"2014","unstructured":"National Heart, Lung, and Blood Institute. 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