Laboratory and clinical outcomes by clinic location
We identified no significant differences in HU monitoring laboratory values for Hb (p=0.6), MCV (p=0.7), HbF (p=0.13), ANC (p=0.9) by clinic location (Table 2). We did not identify a difference in all admissions to the hospital (p=0.5) or pain admissions to the hospital (p=0.6) between academic center vs. satellite clinic patients. However, academic center patients did have a higher number of acute pain visits (p=0.03) to either the ED or UAB pediatric pain clinic (Table 3). As expected, among all participants, non-adherence to HU (HbF <5%) was associated with the highest number of admissions (p=0.02). Among 149 patients with more than one clinic visit, 97 (65%) patients had more than 65% of clinic visits with a correct dose adjustment; we identified no statistical difference in correct dosing adjustment among Birmingham patients (67%) and satellite clinic patients (62%, p=0.5). Patients cared for at the academic center had a statistically higher number of clinic visits (p=0.01) and more patients that attended >2 clinic visits. HbF response was significantly associated with the number of clinic visits (p=0.03). Finally, HbF response was significantly inversely correlated with age (p=0.003). Adjusting for clinic location, number of clinic visits, and age, HbF was associated with age (p=0.006) and clinic visits (p=0.006), but not associated with clinic location.