title: A randomized controlled trial studying the effectiveness of group medical appointments on self-efficacy and adherence in sickle cell disease (TEAM study): study protocol.
abstract: BACKGROUND
  Sickle cell disease (SCD) is endemic in non-Western countries. Due to migration, the prevalence of SCD in the Netherlands has increased. Adherence to medical treatment is recognized as a major problem area. Therefore, new effective interventions to increase adherence are urgently needed.
  
  
  METHODS
  The TEAM study is an ongoing randomized controlled trial (RCT) to compare protocolized individual medical appointments (IMA's; care-as-usual) with protocolized group medical appointments (GMA's; novel intervention) in pediatric (n = 40) and adult (n = 60) patients. The study aims to assess the effectiveness of GMA's (over a three year period) on patients' self-efficacy, adherence, quality of life, morbidity, hospital admissions and satisfaction with the treating professional; as well as to test the cost-effectiveness of GMA's. In both the IMA and GMA groups structured assessments will be performed at baseline (start of the study), after 1.5 and after 3 years.
  
  
  CONCLUSIONS
  This is the first RCT to investigate the effectiveness of GMA's on self-efficacy and adherence in pediatric and adult patients with SCD, including a cost-effectiveness analysis.
  
  
  BACKGROUND
  NTR4750 (NL42182.000.12). Registered 13 August 2014.
authors: Department of Pediatric Hematology, Erasmus University Medical Center - Sophia Children's Hospital, Wytemaweg 80, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
authors: Marlous J
authors: MJ
authors: Madderom
authors: Department of Pediatric Hematology, Erasmus University Medical Center - Sophia Children's Hospital, Wytemaweg 80, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
authors: Jessica
authors: J
authors: Heijdra
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center - Sophia Children's Hospital, Wytemaweg 80, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
authors: Elisabeth M W J
authors: EM
authors: Utens
authors: Department of Public Health, Erasmus University Medical Center, 's-Gravendijkwal 2030, PO 2040, 3000 CA Rotterdam, The Netherlands.
authors: Suzanne
authors: S
authors: Polinder
authors: Department of Hematology, Erasmus University Medical Center, 's-Gravendijkwal 230, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
authors: Anita W
authors: AW
authors: Rijneveld
authors: Department of Pediatric Hematology, Erasmus University Medical Center - Sophia Children's Hospital, Wytemaweg 80, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
authors: Marjon H
authors: MH
authors: Cnossen
keywords: Adherence; Cost-effectiveness; Group medical appointment; Randomized controlled trial; Self-efficacy; Sickle cell disease