Sickle Cell Disease Education in Low and Middle Income Countries Using a Smartphone Clinical Case Discussion App

Introduction Sickle cell disease (SCD) is one of the world's most common hemoglobinopathies, affecting over 400,000 newborns annually (Archer et al., 2022). Despite the World Health Organisation's (WHO) 2006 long-term goals to address the SCD burden, the disease's mortality, particularly within low- and middle-income countries (LMICs) such as India and Sub-Saharan Africa (SSA), remains high (WHO 2006). Barriers to improving outcomes for SCD patients in LMICs include a lack of awareness around treatment guidelines and inadequate clinical knowledge among healthcare professionals (HCPs). While effective medical education programs are essential to the provision of high-quality healthcare services, the delivery of such programs in LMICs is challenging due to limited budgets, poor training infrastructure and equipment, and insufficient educators (Barteit et al., 2020). Recently, consideration has been given to the role that digital learning platforms could play in supporting medical education in LMICs (Nicoll et al., 2018). Aim To assess the impact of a smartphone app delivered medical education program in improving HCP clinical knowledge around SCD in LMICs, focused on SSA (Kenya, Ghana, Zambia, Uganda,Tanzania) and India. Methods The SCD program was developed by subject matter experts with MedShr, a secure app- and web-based clinical case discussion platform freely accessible to HCPs worldwide. The program's focus was determined at the outset through a needs-based approach. Analysis of MedShr's proprietary data enabled the identification of key knowledge gaps among HCPs that could be addressed with case-based education, forming the basis for three themes: 1) Acute SCD presentations 2) Chronic SCD complications 3) Long-term SCD management 9 clinical cases comprising a patient vignette, open question and integrated poll were developed by MedShr in line with the program themes. A case example is displayed in Figure 1. Content delivery via the MedShr platform was from August 2022 to February 2023, during which time the cases were promoted to relevant HCPs via email, push notifications and social media. All content was featured within a SCD Global Education Network group on MedShr, connecting target HCPs and facilitating peer-to-peer discussion. Results During the 6 month program, over 173,000 HCPs were reached globally with the educational content, including 75,070 clinicians in SSA and 64,210 in India. HCPs reached included community health workers (28%), GPs (24