Return Visit Rates after an Emergency Department Treat-and-Release Visit for Children with Sickle Cell Pain Episodes

Sickle Cell Disease Treatment with Arginine Therapy (STArT): study protocol for a phase 3 randomized controlled trial

“…Building on the strength of established partnerships between committed investigators in Emergency Medicine and Hematology developed through a previous trial in PECARN [ 11 ], we will conduct this trial at 10 sites in PECARN. A previous trial for SCD-VOE in PECARN was one of the few trials for SCD-VOE to accrue patients in the goal enrollment period [ 11 , 43 – 45 ]. Additionally, pre-screening and pre-enrollment consenting in Hematology clinics use substantial resources and only a proportion of children, adolescents, and young adults with SCD who are seen in clinic develop SCD-VOE shortly thereafter.…”

“…Enrollment in the ED through research coordinators physically located in the ED allows for real-time education of patients and their caregivers and enables consent of caregivers while in the ED, as they often leave after hospital admission to attend to other issues in the home. Providing education about the study to all patients with SCD and their families while in the ED regardless of their eligibility offers families time to ask questions, review materials, and speak with their hematologists before consenting, a strategy that increases participation rates during a future ED visit, particularly since nearly 30% of ED treat-and-release visits for SCD pain episodes within PECARN sites have return ED visits within 14 days [ 45 ]. Pre-consent in the ED for future visits, and not just in hematology clinics, may also facilitate enrollment in future ED encounters.…”