Walk-in and in-home care models help access to sickle cell treatment

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For people who live with sickle cell disease, episodes of pain can be frequent, sudden and debilitating. A severe event often forces patients to the emergency room for treatment, but this can result in hours of waiting without relief from the intense pain.

Payal Desai, MD, a hematologist who leads the OSUCCC – James Sickle Cell Program, recognized an opportunity to do better for these patients.

Under her leadership, in January 2017 the OSUCCC – James opened a day hospital where sickle cell patients can receive immediate treatment for acute episodes of severe pain and other symptoms related to their disease. Located on the fifth floor of the main hospital, the OSUCCC – James Sickle Cell Day Hospital is staffed by nurses and physicians who specialize in sickle cell disease. The unit has six infusion units and is open for walk-in care five days per week from 8 a.m. to 6 p.m.

“We don’t want people to wait until they are miserable to seek treatment for their sickle cell-related pain. We have reliable ways to help patients find relief quickly, and postponing treatment makes them far more likely to need inpatient treatment to get back to normal. Our hope is that patients will seek help more quickly through this walk-in treatment,” says Desai.

Desai says she and her colleagues have already seen results, estimating they have reduced admissions for pain by about 50 percent since they opened the day hospital.

Sickle cell anemia is a benign (noncancerous) blood disease in which the body produces an abnormal hemoglobin that causes cells to change from a round shape to that of a sickle, or a crescent.

It’s an inherited disorder that affects 70,000-100,000 Americans. The abnormal sickle shape makes the cells stiff and sticky, preventing them from moving normally through the bloodstream. These abnormal cells can block blood flow, causing pain, organ damage and an increased risk for infection.

For patients who have difficulty getting to a doctor’s office for followup care, the OSUCCC – James also recently launched a home visit program to help remove barriers to accessing preventive care. About 30 patients are receiving in-home services through the program from Andrew Schamess, MD. “Our goal is to address the big medical issues — particularly vision, hearing and pain management — earlier, when we can do more to manage them,” says Desai.

To learn more about sickle cell clinical care and research at the OSUCCC – James, visit cancer.osu.edu.