Primary Care Providers' Comfort Levels in Caring for Patients with Sickle Cell Disease.
OBJECTIVE
The purpose of this study was to determine the comfort levels of primary care providers in caring for individuals with sickle cell disease (SCD) and determine factors that improved or lessened provider comfort.


METHODS
We surveyed providers at the annual Johns Hopkins Community Physicians retreat. The survey consisted of 19 questions and measured comfort levels in four domains: providing ambulatory care to individuals with SCD, managing SCD comorbidities, managing SCD-specific issues, and managing chronic pain. We conducted bivariate analyses to identify any demographic or practice characteristics associated with comfort levels. Multivariable analyses were conducted to identify independent correlates of physician comfort.


RESULTS
The majority of respondents lacked confidence with each of the four aspects of caring for individuals with SCD. Having treated patients with SCD and using knowledge from residency were both independently associated with increased confidence when providing ambulatory care and managing SCD-specific issues in multivariable analyses.


CONCLUSIONS
The delivery of high-quality care to adults with SCD in primary care may be limited because of a lack of provider comfort in providing that care. Because provider reliance on knowledge gained from residency significantly affected the management of patients with SCD, it is essential that continuing medical education on SCD is readily available to ensure that providers are using current information and knowledge. In addition, as comfort increases with the number of patients with SCD in a provider's panel, it may be beneficial to identify a subset of primary care providers interested in SCD and refer patients to those providers.
From the Departments of Medicine and Pediatrics, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Lauren N
LN
Whiteman
From the Departments of Medicine and Pediatrics, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Carlton
C
Haywood
From the Departments of Medicine and Pediatrics, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Sophie
S
Lanzkron
From the Departments of Medicine and Pediatrics, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
John J
JJ
Strouse
From the Departments of Medicine and Pediatrics, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Leonard
L
Feldman
From the Departments of Medicine and Pediatrics, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Rosalyn W
RW
Stewart
D000328:Adult; D000553:Ambulatory Care; D000755:Anemia, Sickle Cell / Q000453:epidemiology / Q000628:therapy*; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D015897:Comorbidity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D059408:Pain Management; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000523:psychology