鎌状赤血球病の新しい介入法が生活の質を改善(New Sickle Cell Disease Intervention May Offer a Path to a Better Quality of Life)

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2025-08-26 コロンビア大学

コロンビア大学看護学部の研究チームは、鎌状赤血球症の思春期患者を対象に、ヒドロキシウレア治療の継続を支援する新しい介入「HABIT」試験を実施した。50名(10~18歳)が参加し、地域医療従事者による家庭訪問、教育資料の提供、日常習慣に組み込んだ服薬支援、3か月間の個別化テキストメッセージリマインダーなどを組み合わせた。9か月時点で精神的健康を含む生活の質が改善されたが、12か月時点では効果が持続しなかった。結果は有望である一方、行動変容を長期的に維持する方法のさらなる研究が必要とされる。研究成果は Pediatric Blood and Cancer に掲載された。

<関連情報>

HABIT有効性試験介入は、若年性鎌状赤血球症患者の一般的および疾患特異的QOL要素を改善する HABIT Efficacy Trial Intervention Improves Elements of General and Disease-Specific Quality of Life in Youth With Sickle Cell Disease

Arlene Smaldone, Deepa Manwani, Banu Aygun, Abena Appiah-Kubi, Kim Smith-Whitley, Nancy S. Green
Pediatric Blood & Cancer  Published: 26 August 2025
DOI:https://doi.org/10.1002/pbc.31990

ABSTRACT

Background

Whether interventions to improve hydroxyurea adherence in youth with sickle cell disease (SCD) also improve health-related quality of life (HRQoL) has not been determined. We prospectively examined changes in generic and disease-specific HRQoL over a 12-month period in youth who participated in “Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT)” randomized controlled multi-site efficacy trial. The HABIT intervention was led by community health workers and augmented by tailored text message reminders.

Methods

Improvements in generic and disease-specific HRQoL were secondary HABIT outcomes. Intervention efficacy and sustainability were measured as changes in HRQoL from Months 0 to 9 and from Months 9 to 12 of the trial, respectively. Data were analyzed for within-group and between-group changes.

Results

Fifty youth, 24 assigned to intervention and 26 to the control group, mean age of 13.3 ± 1.9 years, participated in the trial. There were no differences between groups at study entry. At Month 0, total generic and disease-specific HRQoL scores were 71.2 ± 15.6 and 62.7 ± 19.0, respectively. At 9 months, compared to controls, the intervention group significantly improved generic HRQoL total score (p = 0.04) and two subscales (emotional, p = 0.03, and social, p = 0.01), and one disease-specific HRQoL subscale (treatment, p = 0.006). HRQoL improvements were not sustained at 12 months.

Conclusions

Findings of this study contribute to the evolving understanding of the impact of interventions to improve hydroxyurea adherence on HRQoL in youth with SCD. Further research directed to enhancing intervention sustainability is needed to maintain hydroxyurea adherence and HRQoL improvements to reduce health disparities for youth with SCD.

医療・健康
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