Facilitators to Access and Utilization of Physical Therapy for People With Sickle Cell Disease

Introduction: The purpose of our study was to explore what characteristics impact access and utilization of physical therapy (PT) for people with sickle cell disease (SCD). Review of Literature: SCD causes functional impairments and decreases quality of life. PT can reduce complications; however, it is unknown what variables impact access and utilization. Subjects: People with SCD who received care in acute care or outpatient settings between 2016-2024. Methods: Variables retrieved included age, race, gender, insurance, area deprivation index, admission type, diagnosis, pain, PT referral and evaluation, and medications. Logistic regression identified factors for predicting access and utilization. Results: Retrieval identified 55 926 episodes with a diagnosis of SCD. Being uninsured decreased referrals (odds ratio [OR] 0.106). Variables that increased referral included age (age 41-60 years, OR 2.166; age >60, OR 3.329), presence of pain (OR 2.131), and access to hydroxyurea (OR 3.196). Age <20 years (OR 0.519) decreased utilization, whereas access to medication (hydroxyurea, OR 4.993; voxelotor, OR 2.719); pain (OR 66.424) and being in the acute care setting (OR 18.403) increased utilization. Conclusion: Variables were found to impact access and utilization. Implementation of these findings may aid in the development of clinical pathways and improve quality of life.