Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study

Effectiveness of an educational programme about sickle cell disease in the form of active methodologies among community health agents and nursing technicians of primary care in Minas Gerais, Brazil

BACKGROUND

The incidence of sickle cell disease (SCD) in newborns in Minas Gerais, Brazil is 1:1400, and is a considerable public health problem. Care for SCD at the primary level is still in its early stages and has not even been assessed even worldwide.

AIM

To evaluate the effectiveness of a training programme about childhood SCD aimed at primary care professionals.

METHODS

Assessment of a SCD training course for 263 community health agents of the Family Health Programme was conducted using pre- and post-testing of knowledge related to epidemiological and clinical issues and management of children with SCD. In one of the three municipalities evaluated, the group that participated in the training (n = 82) was compared with a control group (n = 75). Active methods that consider trainees as the key protagonists of the educational programme were used throughout. The control group did not receive any training on SCD during the period.

RESULTS

There was a significant increase in correct answers to questions after the intervention in the three municipalities (P < 0.001). This increase was significant in all the domains of the questionnaire. In a multivariate analysis, professionals in the intervention group showed a post- and pre-test score difference that was 8.7 times higher than that in the control group (95% CI 7.8-9.6). The length of employment as a community health worker had a modest positive effect on the difference in scores (P = 0.046).

CONCLUSION

The educational intervention proved effective in increasing health care providers' knowledge.

Patients' views on improving sickle cell disease management in primary care: focus group discussion

Objectives

To assess sickle cell disease (SCD) patient and carer perspectives on the primary care services related to SCD that they receive from their general practitioner (GP).

Design

A focus group discussion was used to elicit the views of patients about the quality of care they receive from their primary health-care providers and what they thought was the role of primary care in SCD management. The focus group discussion was video recorded. The recording was then examined by the project team and recurring themes were identified. A comparison was made with notes made by two scribes also present at the discussion.

Setting

Sickle Cell Society in Brent, UK.

Participants

Ten participants with SCD or caring for someone with SCD from Northwest London, UK.

Main outcome measures

Patients' perceptions about the primary care services they received, and a list of key themes and suggestions.

Results

Patients and carers often bypassed GPs for acute problems but felt that GPs had an important role to play around repeat prescriptions and general health care. These service users believed SCD is often ignored and deemed unimportant by GPs.

Conclusion

Participants wanted the health service to support primary health-care providers to improve their knowledge and understanding of SCD. Key themes and suggestions from this focus group have been used to help develop an educational intervention for general practice services that will be used to improve SCD management in primary care.