TY - JOUR
AU - C. R. R. Rodgers
AU - A. S. Breslow
AU - G. Parry
AU - G. Sims
AU - E. C. Chambers
AU - D. G. Manwani
AU - B. L. Cook
A1 - 
AB - BACKGROUND: Adolescents and young adults (AYA) living with sickle cell disease (SCD) transitioning to adult hematology care are at risk of dropping out of care and relying on emergency departments (ED) for acute crisis management. This can result in decreased continuity of care, an increase in serious health complications, and a greater mortality risk. This study aimed to investigate how transitioning to adult care is associated with SCD treatment outcomes, and test whether this association is moderated by comorbid mental health concerns (i.e., symptoms of anxiety and depression). PROCEDURE: We tested differences by age group (16-20, 21-25, 26-33 years) in the number of opioid prescriptions, hydroxyurea prescriptions, and ED visits using unadjusted comparisons and multivariable regression models, hypothesizing increased acute care use and decreased preventive treatment among the older age groups due to the complications associated with transitioning to adult care. We also tested whether there was an exacerbating effect of depression and anxiety symptoms on transition by assessing interaction terms between age group and symptoms in regression models. RESULTS: After adjusting for sociodemographic and mental health symptoms, the 26-33-year-old group had a significantly higher number of opioid prescriptions, and the 21-25 and 26-33 year groups had fewer hydroxyurea prescriptions and a greater number of ED visits than their 16-20-year-old counterparts. The higher number of opioid prescriptions among the older age group was even more pronounced among those with moderate to severe anxiety symptoms. CONCLUSIONS: Transitioning from pediatric to adult hematology poses a significant risk for AYA with SCD, especially for those with anxiety symptoms.
AD - Albert Einstein College of Medicine, Bronx, New York, USA.; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA.; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York, USA.; The Children's Hospital at Montefiore, Bronx, New York, USA.; Montefiore Medical Center, Bronx, New York, USA.; Cambridge Health Alliance, Cambridge, Massachusetts, USA.; Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
AN - 41277307
BT - Pediatr Blood Cancer
C5 - Healthcare Disparities
CP - 2
DA - Feb
DO - 10.1002/pbc.32146
DP - NLM
ET - 20251124
IS - 2
JF - Pediatr Blood Cancer
LA - eng
N2 - BACKGROUND: Adolescents and young adults (AYA) living with sickle cell disease (SCD) transitioning to adult hematology care are at risk of dropping out of care and relying on emergency departments (ED) for acute crisis management. This can result in decreased continuity of care, an increase in serious health complications, and a greater mortality risk. This study aimed to investigate how transitioning to adult care is associated with SCD treatment outcomes, and test whether this association is moderated by comorbid mental health concerns (i.e., symptoms of anxiety and depression). PROCEDURE: We tested differences by age group (16-20, 21-25, 26-33 years) in the number of opioid prescriptions, hydroxyurea prescriptions, and ED visits using unadjusted comparisons and multivariable regression models, hypothesizing increased acute care use and decreased preventive treatment among the older age groups due to the complications associated with transitioning to adult care. We also tested whether there was an exacerbating effect of depression and anxiety symptoms on transition by assessing interaction terms between age group and symptoms in regression models. RESULTS: After adjusting for sociodemographic and mental health symptoms, the 26-33-year-old group had a significantly higher number of opioid prescriptions, and the 21-25 and 26-33 year groups had fewer hydroxyurea prescriptions and a greater number of ED visits than their 16-20-year-old counterparts. The higher number of opioid prescriptions among the older age group was even more pronounced among those with moderate to severe anxiety symptoms. CONCLUSIONS: Transitioning from pediatric to adult hematology poses a significant risk for AYA with SCD, especially for those with anxiety symptoms.
PY - 2026
SN - 1545-5009
SP - e32146
ST - The Role of Associated Treatment Factors and Mental Health on Transition From Pediatric to Adult Care for Adolescent/Young Adults With Sickle Cell Disease
T1 - The Role of Associated Treatment Factors and Mental Health on Transition From Pediatric to Adult Care for Adolescent/Young Adults With Sickle Cell Disease
T2 - Pediatr Blood Cancer
TI - The Role of Associated Treatment Factors and Mental Health on Transition From Pediatric to Adult Care for Adolescent/Young Adults With Sickle Cell Disease
U1 - Healthcare Disparities
U3 - 10.1002/pbc.32146
VL - 73
VO - 1545-5009
Y1 - 2026
ER -