The Effect of Barriers on Health Related Quality of Life (HRQL) and Compliance in Adult Asthmatics who are followed in an Urban Community Health Care Facility

摘要

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 who receive follow-up care for asthma at either Bloomfield-Garfield (BG) or Latterman Family Health Care Center (LFHC) 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 LFHC 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 quality of life 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 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 (or even exclusively) 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.