Effects of Barriers on Quality of Life and Compliance in Adult Asthmatics
Effects of Barriers on Quality of Life and Compliance in Adult Asthmatics
This cross sectional descriptive study sought to identify perceived barriers to follow-up care for adult asthmatics who are followed in two community health care facilities. A second purpose of the study was to determine the effect of any barriers to Health Related Quality of Life (HRQL) and compliance in the sample. Thirty-four adults completed a demographic and health status survey, the MiniAQLQ and the EWash Access to Health Care Survey. "Long waiting time in provider's office," "someone had to miss work," "cost of care too much, "and "long wait for an appointment" were the most prevalent perceived barriers in the sample. "Lack of transportation" was significantly associated with study participants who receive health care at one site or who stated the emergency room as their usual place of care. "Someone had to miss work" was significantly correlated with the following variables: employment, a higher annual household income, 1-2 daily medications for asthma, no overnight hospitalizations for asthma and no psychological co-morbidities. A higher reported HQOL was significantly correlated with study participants whose medical care needs were met and found access to local health care services. The only perceived barrier that was significantly correlated with compliance was study participants who "sometimes" had to reschedule an appointment with a health care provider due to "lack of transportation." The present study suggests that strategies designed to decrease the perceived barriers might improve compliance with the treatment regime, thus decreasing costs, absenteeism, and lack of continuity.
Asthma is a major public health problem in the United States. According to the 2006 National Health Interview Survey, approximately 11% of adults 18 years of age or older have been diagnosed with asthma and the disease is not limited to age, ethnic origin, or socioeconomic status. The disease has been associated with familial, infectious, allergenic, socioeconomic, psychosocial, and environmental factors. Asthma is responsible for approximately 10 million physician office visits, over 100 million days of restricted activity, and total annual costs of over $11 billion.
The impact of socioeconomic status on health care and use of medical services has been studied with a variety of chronic disease states including asthma. Additional studies have shown that insurance coverage, in and of itself, do not guarantee use of timely and appropriate medical care. Some health system organizational obstacles, other than financial reimbursement, faced by asthma sufferers include difficulty scheduling follow-up appointments, lack of continuity in provider, long waiting times in a health care facility, inconvenient office hours and cultural insensitivity. Some clinician-related barriers to adherence in adults may be staff or physician disinterest and limited time to answer specific questions related to treatment regime. Finally, economic barriers, besides insurance coverage include insufficient sick leave, child care costs, limited or inadequate transportation to the provider's site of care and out-of-pocket medical expenses, such as medication and treatment co-payments. If organizational, clinician or patient-specific factors are significant barriers, they may result in delays in follow-up care and adverse health outcomes independent of health insurance. Since asthma is a chronic disease that can be successfully managed in a community setting, it is important to ascertain the barriers that influence the patient's ability to receive quality health care in the community.
Although the relationship between health related quality of life (HRQL) and asthma has been studied from a treatment regime, little research exists that examine the effects of barriers and/or facilitators on HRQL. Some barriers cited that showed a relationship between HRQL and asthma include health care beliefs ("I do not understand everything I have been told about my disease") accessibility of provider and health care utilization. Other studies have found that consultation with a physician, follow-up telephone calls, therapeutic treatments by an allergist or behavioral interventions that promote self management have an effect of HRQL. However, little research exists that identifies the barriers and/or facilitators of follow-up asthma care in community and its effect on HRQL. As a result of the chronic nature of the disease, the potential for life-threatening exacerbations, and the burden of day-to-day management, it is imperative that researchers identify those specific barriers that hinder care so that effective interventions and congruent health policies are developed.
The purpose of this study is to determine self reported barriers for follow-up care among adult asthmatic patients receiving care from urban community health care facilities. Two secondary purposes are to determine what effect these barriers have on HRQL and compliance with follow-up health care management.
This cross sectional descriptive study sought to identify perceived barriers to follow-up care for adult asthmatics who are followed in two community health care facilities. A second purpose of the study was to determine the effect of any barriers to Health Related Quality of Life (HRQL) and compliance in the sample. Thirty-four adults completed a demographic and health status survey, the MiniAQLQ and the EWash Access to Health Care Survey. "Long waiting time in provider's office," "someone had to miss work," "cost of care too much, "and "long wait for an appointment" were the most prevalent perceived barriers in the sample. "Lack of transportation" was significantly associated with study participants who receive health care at one site or who stated the emergency room as their usual place of care. "Someone had to miss work" was significantly correlated with the following variables: employment, a higher annual household income, 1-2 daily medications for asthma, no overnight hospitalizations for asthma and no psychological co-morbidities. A higher reported HQOL was significantly correlated with study participants whose medical care needs were met and found access to local health care services. The only perceived barrier that was significantly correlated with compliance was study participants who "sometimes" had to reschedule an appointment with a health care provider due to "lack of transportation." The present study suggests that strategies designed to decrease the perceived barriers might improve compliance with the treatment regime, thus decreasing costs, absenteeism, and lack of continuity.
Asthma is a major public health problem in the United States. According to the 2006 National Health Interview Survey, approximately 11% of adults 18 years of age or older have been diagnosed with asthma and the disease is not limited to age, ethnic origin, or socioeconomic status. The disease has been associated with familial, infectious, allergenic, socioeconomic, psychosocial, and environmental factors. Asthma is responsible for approximately 10 million physician office visits, over 100 million days of restricted activity, and total annual costs of over $11 billion.
The impact of socioeconomic status on health care and use of medical services has been studied with a variety of chronic disease states including asthma. Additional studies have shown that insurance coverage, in and of itself, do not guarantee use of timely and appropriate medical care. Some health system organizational obstacles, other than financial reimbursement, faced by asthma sufferers include difficulty scheduling follow-up appointments, lack of continuity in provider, long waiting times in a health care facility, inconvenient office hours and cultural insensitivity. Some clinician-related barriers to adherence in adults may be staff or physician disinterest and limited time to answer specific questions related to treatment regime. Finally, economic barriers, besides insurance coverage include insufficient sick leave, child care costs, limited or inadequate transportation to the provider's site of care and out-of-pocket medical expenses, such as medication and treatment co-payments. If organizational, clinician or patient-specific factors are significant barriers, they may result in delays in follow-up care and adverse health outcomes independent of health insurance. Since asthma is a chronic disease that can be successfully managed in a community setting, it is important to ascertain the barriers that influence the patient's ability to receive quality health care in the community.
Although the relationship between health related quality of life (HRQL) and asthma has been studied from a treatment regime, little research exists that examine the effects of barriers and/or facilitators on HRQL. Some barriers cited that showed a relationship between HRQL and asthma include health care beliefs ("I do not understand everything I have been told about my disease") accessibility of provider and health care utilization. Other studies have found that consultation with a physician, follow-up telephone calls, therapeutic treatments by an allergist or behavioral interventions that promote self management have an effect of HRQL. However, little research exists that identifies the barriers and/or facilitators of follow-up asthma care in community and its effect on HRQL. As a result of the chronic nature of the disease, the potential for life-threatening exacerbations, and the burden of day-to-day management, it is imperative that researchers identify those specific barriers that hinder care so that effective interventions and congruent health policies are developed.
The purpose of this study is to determine self reported barriers for follow-up care among adult asthmatic patients receiving care from urban community health care facilities. Two secondary purposes are to determine what effect these barriers have on HRQL and compliance with follow-up health care management.
Source...