Paper
Sunday, November 4, 2007
145
The Effects of Barriers on Health Related Quality of Life HRQL and Compliance in Adult Asthmatics who are followed in an Urban Community Healthcare Facility
Rosemary L. Hoffmann, PhD, RN, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| Learning Objective #1: state the perceived barriers for adult asthmatics who are followed in an urban community health care facility. |
| Learning Objective #2: related perceived barriers to health related quality of life and compliance in adult asthmatics followed in community facilities. |
Aday and Anderson’s access to health care model was the basis for this cross sectional descriptive study to identify perceived barriers to follow-up care for adult asthmatics who are followed in two community health care facilities. A second purpose sought to determine the effect of any barriers to health related quality of life and compliance. Thirty-four adults who receive follow-up care for asthma 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 missed 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 missed work” was significantly correlated with the following variables: employment, a higher annual household income, 1-2 daily asthma medications, no overnight hospitalizations for asthma and no psychological co-morbidities. A higher reported quality of life was significantly correlated with study participants whose medical care needs were met and found access to health care services. The only perceived barrier that was significantly correlated with compliance was study participants who “sometimes” had to reschedule a health care appointment due to “lack of transportation.” The present study suggests that strategies designed to decrease the perceived barriers of lack of transportation, a patient or family member missing work, long wait for an appointment, and inconvenient office hours may improve follow-up care in this population. Such strategies would operate primarily through improving access and thus fostering asthma care in the community where it can be effectively managed. A program that limits barriers might improve compliance with the treatment regime, thus decreasing costs, absenteeism, and lack of continuity.