Hydroxyurea Adherence for Personal Best in Sickle Cell Disease (HABIT): Efficacy Trial
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ClinicalTrials.gov Identifier: NCT03462511 |
Recruitment Status :
Completed
First Posted : March 12, 2018
Last Update Posted : December 12, 2022
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Condition or disease | Intervention/treatment | Phase |
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Sickle Cell Disease | Behavioral: HABIT Intervention | Not Applicable |
Barriers to medication adherence are common in youth with chronic illness and are a source of racial/ethnic disparities in underserved communities. An inherited blood disease, Sickle Cell Disease (SCD) is characterized by chronic and acute illness and reduced quality of life (QOL). It affects African Americans and other underserved communities. Hydroxyurea (HU) is the sole FDA-approved drug therapy for SCD and is highly effective and improves QOL. Poor adherence is common among youth and young adults with SCD.
The importance of poor medication adherence, use of community-based health workers (CHWs) to bridge the gap between health services and underserved parent-youth dyads affected by SCD, the strength of the science, the success of the investigators' multi-ethnic feasibility study, and the potential application of study findings to youth with other serious chronic illnesses speak to the importance of this trial.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 100 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Health Services Research |
Official Title: | Hydroxyurea Adherence for Personal Best in Sickle Cell Disease (HABIT): Efficacy Trial |
Actual Study Start Date : | August 15, 2018 |
Actual Primary Completion Date : | December 31, 2021 |
Actual Study Completion Date : | December 31, 2021 |

Arm | Intervention/treatment |
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Active Comparator: Control Group
Dyads randomized to the control group will receive: Standard care Education handouts. |
Behavioral: HABIT Intervention
In addition to standard care and education handouts, dyads randomized to the intervention group will receive the HABIT intervention, which includes CHW support and tailored text messages. |
Experimental: Intervention Group
In addition to standard care and education handouts, dyads randomized to the intervention group will receive the HABIT intervention, which includes CHW support and tailored text messages.
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Behavioral: HABIT Intervention
In addition to standard care and education handouts, dyads randomized to the intervention group will receive the HABIT intervention, which includes CHW support and tailored text messages. |
- Mean change in biomarker HbF [ Time Frame: 0 months, 6 months and 12 months ]Used to measure hydroxyurea adherence
- Mean change in proportion of days covered by hydroxyurea (using prescription refill data) [ Time Frame: Up to 12 months ]Used to measure hydroxyurea adherence
- Mean change in score on Peds Quality of Life (generic quality of life) [ Time Frame: 0 months, 6 months and 12 months ]Used to measure health-related quality of life
- Mean change in score on PedsQL Sickle Cell Disease module (disease specific quality of life) [ Time Frame: 0 months, 6 months and 12 months ]Used to measure health-related quality of life
- Mean change in score on Sickle Cell Family Responsibility instrument [ Time Frame: 0 months, 6 months and 12 months ]Used to measure parent/youth concordance regarding delegation of self-management responsibility by mean change in dyad concordance

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Ages Eligible for Study: | 10 Years to 18 Years (Child, Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria - Youth:
- One of the two most common sickle cell disease variants (HbSS or HbS-B0 thalassemia)
- Age 10 through18 years (inclusive)
- Currently prescribed hydroxyurea (HU) ≥18 months (for identifying historical Personal best HbF)
- Current HU dose is within 5% of dose at Personal Best HbF
- Pre-enrollment HbF ≥15% below historical Personal best, based on mean of ≥2 HbF assessments over preceding 12 months
- Youth able to speak/read English or Spanish
Inclusion Criteria - Parent:
- Parent/guardian speaks/reads English or Spanish
- Parent/ legal guardian willing to participate
- Family expects to reside in community for ≥ 1.5 years
Exclusion Criteria - Youth:
- Youth not prescribed HU
- <2 HbF assessments over past 12 months
- Transfusion within 3 months preceding enrollment
- Final screen HbF (visit 0) of ≤15% decrease below Personal best HbF
- Sexually active female 10 years or older and not using reliable contraception (due to HU teratogenic risk)
- Pregnancy
- Cognitive impairment (>2 levels below expected grade)
- Youth not residing with parent/legal guardian
Exclusion Criteria - Parent:
- Parent/legal guardian does not reside with youth

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03462511
United States, New York | |
Albert Einstein College of Medicine | |
Bronx, New York, United States, 10461 | |
Feinstein Institute for Medical Research | |
Manhasset, New York, United States, 11030 | |
Columbia University Irving Medical Center | |
New York, New York, United States, 10032 | |
United States, Pennsylvania | |
The Children's Hospital of Philadelphia | |
Philadelphia, Pennsylvania, United States, 19104 |
Principal Investigator: | Arlene Smaldone, PhD, CPNP-PC | Columbia University School of Nursing | |
Principal Investigator: | Nancy S Green, MD | Columbia University |
Responsible Party: | Arlene Smaldone, Professor of Nursing, Columbia University |
ClinicalTrials.gov Identifier: | NCT03462511 |
Other Study ID Numbers: |
AAAR2908 1R01NR017206-01 ( U.S. NIH Grant/Contract ) |
First Posted: | March 12, 2018 Key Record Dates |
Last Update Posted: | December 12, 2022 |
Last Verified: | December 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Hydroxyurea Community health worker (CHW) Text messages Medication adherence |
Anemia, Sickle Cell Anemia, Hemolytic, Congenital Anemia, Hemolytic Anemia |
Hematologic Diseases Hemoglobinopathies Genetic Diseases, Inborn |