An Imperial College team analysed 1,090 emergency hospital admissions for sickle cell disease over 30 months in the London borough of Brent, an area of high prevalence for the disease.
The researchers found that 74% of all bed days for patients admitted with sickle cell disease were associated with those who had been admitted multiple times during the analysis period.
The researchers believe that long-term management of uncomplicated sickle cell pain episodes may be more efficiently managed in a primary care setting. They suggest that patients who are admitted multiple times over short periods may be good candidates for GP interventions.
Primary care interventions would reduce patients’ risk of SCD-related complications and be more cost effective for the NHS than hospital admissions, the researchers argue. Interventions that move management of sickle cell disease from tertiary towards primary care have been successfully implemented in Sheffield and elsewhere, they point out.
Previous research has also shown that a 40% reduction in sickle cell A&E attendance can be achieved by allowing sickle cell disease patients to bypass A&E and receive primary care treatment within hospital.
The researchers said they would now identify GP practices with the highest numbers of sickle cell disease patients who frequently seek emergency care. These practices will be earmarked for an education intervention designed to help further engage GPs in the care and management of patients with sickle cell disease.
The researchers concluded: ‘More appropriate management of sickle cell disease patients in the community may contribute to better health outcomes for patients, as well as economic benefits for the local health economy.’