Reframing sickle cell disease care: improving care with an embedded primary care model for chronic comorbidity management.

INTRODUCTION: We are in a new era of unprecedented therapeutic possibilities in sickle cell disease (SCD). However, disease-modifying therapies alone will not fix a care system that leaves prevention, chronic comorbidity management, and mental health behind. Patient-centered SCD care must address the whole person, not hematology care alone.

AREAS COVERED: We review primary care and preventive needs within SCD, the current fragmented model, and a novel embedded primary care provider (PCP) model. PubMed and Google Scholar were searched from database inception through August 2026 for English-language literature on SCD, primary care, preventive care, mental health, care fragmentation, and embedded care models.

EXPERT OPINION: SCD is entering a new era of care; however, one glaring issue is the current fragmented care model. A model that puts patient goals at the center and makes primary care a core element can make today's evidence-based recommendations more achievable. The shift in SCD care is not about moving away from the hematologist, but building the comprehensive support that patients need. By embedding a PCP into SCD teams, programs may be able to deliver preventive care, address depression and anxiety, manage chronic disease, and translate guidelines into routine practice.