Limitations:
The methods utilized to enroll patients in this study likely led to a selection bias considering the responses were only from those participants that the study team was able to communicate with directly utilizing only the contact information available in the hematology section database and electronic medical record. A large percentage of potentially eligible subjects were unable to be reached, which may indicate higher level of economic instability and potentially additional challenges with access to care and changes in contact information. This may have contributed to the discrepancy in results related to outpatient visits and it’s lack of correlation with ED and hospital visits since this cohort may not represent patients that might be more transitory, leading to fewer outpatient visits with potentially higher frequency of ED visits. Additionally, this was a small cohort of patients from a single institution, so may not be an accurate representation of adult patients with SCD from other institutions or geographical locations.