PICOT – Patients with Sickle Cell Disease Experiencing a Vaso-occlusive Crisis

PICOT – Patients with Sickle Cell Disease Experiencing a Vaso-occlusive Crisis

In patients with sickle cell disease experiencing a vaso-occlusive crisis (P), how does hydroxyurea therapy (I) compared to blood transfusions (C) improve pain response (O) during hospitalization (T)?

Article 1: Impact of Hydroxyurea therapy on reducing pain

Question: Briefly describe the article (1) and then the outcomes relevant to your PICOT outcome(s) as they are reported in your selected article.

The study sought to assess the effectiveness of hydroxyurea therapy in reducing pain crises, hospital admissions, and length of stay for sickle cell disease, as well as identify the likely impediments to using this medication as a therapeutic option. Per the findings, hydroxyurea maintains effectiveness in lowering pain crises for patients with sickle cell disease. Approximately 35% of the patients on hydroxyurea reported no pain crises, compared to 32% in non-users. Hospitalization was also low with hydroxyurea therapy, as 66.2% of the patients were never hospitalized (Albohassan et al., 2022). These findings affirmed that hydroxyurea is effective in diminishing painful vaso-occlusive crises as well as the number of hospitalizations for patients with sickle cell disease, compared with other therapeutic options.

Article 2: Red blood cell transfusion therapy for sickle cell patients with frequent painful events. 

 Question: Describe the validity and reliability of the measure (if this is not applicable, relevant, or not available, make a note of it)

Acute vaso-occlusive pain crisis remains a hallmark manifestation of sickle cell disease. A red blood cell transfusion therapy program has been proven to reduce pain episodes. The author does not demonstrate the program’s validity and reliability measures. Validity in research defines the degree to which a research method measures what it is intended for. It points to the accuracy of the findings. In the article presented, validity will inform on whether red blood cell transfusion therapy can be implemented in larger populations or the management of vaso-occlusive pain crises (Hilliard et al., 2018). Reliability in research, on the other hand, defines the consistency and stability of the research findings.

Relevance of your 2 Selected Outcomes for Practice

1. Consider, describe, and link the relevance of the two article outcomes to your PICOT question for your practice setting.

The two articles detail the intervention, population, and outcome parts of the PICOT formatted question. They outline specific therapeutic options that can be used to address vaso-occlusive pain crises for hospitalized patients. While the first article is specific on hydroxyurea and compares it with other interventions, the second article is on the applicability of red blood cell transfusion therapy in managing vaso-occlusive therapy.

• Are the outcomes appropriate to measure in practice as they were described in the articles for your selected population?

The outcomes of the articles are appropriate and measurable. As described in the articles, pain reduction is the focus of the research. This outcome can be measured by evaluating the patients after initiation of therapy.

References

Albohassan, H., Ammen, M., Alomran, A. A., Bu Shehab, H., Al Sakkak, H., & Al Bohassan, A. (2022). Impact of hydroxyurea therapy in reducing pain crises, hospital admissions, and Length of stay among sickle cell patients in the Eastern region of Saudi Arabia. Cureus. https://doi.org/10.7759/cureus.31527

Hilliard, L. M., Kulkarni, V., Sen, B., Caldwell, C., Bemrich‐Stolz, C., Howard, T. H., Brandow, A., Waite, E., & Lebensburger, J. D. (2018). Red blood cell transfusion therapy for sickle cell patients with frequent painful events. Pediatric Blood & Cancer, 65(12). https://doi.org/10.1002/pbc.27423

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Patients with Sickle Cell Disease Experiencing a Vaso-occlusive Crisis

In patients with sickle cell disease experiencing a vaso-occlusive crisis (P), how does hydroxyurea therapy (I), compared to blood transfusions (C), improve pain response (O) during hospitalization (T)?

Article 1:

Impact of Hydroxyurea therapy on reducing pain

Question: Briefly describe the article (1) and then the outcomes relevant to your PICOT outcome(s) as they are reported in your selected article.

Article 2:

Red blood cell transfusion therapy for sickle cell patients with frequent painful events. 

 Question: Describe the validity and reliability of the measure (if this is not applicable,
relevant or not available, make a note of it)

Relevance of your 2 Selected Outcomes for Practice

1. Consider, describe, and link the relevance of the two article outcomes to your PICOT question for your practice setting.

• Are the outcomes appropriate to measure in practice as they were described in the articles for your selected population?
  • If yes, why?
  • If no, why not?