Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study
Abstract Background Anticoagulation with warfarin represents a transportation‐sensitive treatment state. Transportation barrier is a common reason for not using health care services. Objective To assess the association between transportation barriers to anticoagulation clinic and anticoagulation con...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12605 |
| _version_ | 1797766348988743680 |
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| author | Connie H. Yan Maryam Naveed Ali Alobaidi Miranda Kopfman Edith A. Nutescu Lisa K. Sharp |
| author_facet | Connie H. Yan Maryam Naveed Ali Alobaidi Miranda Kopfman Edith A. Nutescu Lisa K. Sharp |
| author_sort | Connie H. Yan |
| collection | DOAJ |
| description | Abstract Background Anticoagulation with warfarin represents a transportation‐sensitive treatment state. Transportation barrier is a common reason for not using health care services. Objective To assess the association between transportation barriers to anticoagulation clinic and anticoagulation control (AC) among an inner‐city, low‐income population. Patients/Methods Adults expected to be on chronic warfarin therapy were recruited from an ambulatory anticoagulation clinic. Participants completed a validated questionnaire that assessed transportation barriers to clinic, defined as self‐reported trouble getting transportation to a clinic and a composite score of the presence of transportation barriers. Suboptimal AC was defined as time in therapeutic range (TTR) <60% over 6 months. Prevalence ratios with 95% confidence intervals (CIs), adjusted for age, sex, and annual household income, described the association of transportation trouble and barriers with AC. Results Of 133 participants, 42.9% had suboptimal AC. Mean age was 60.4 (SD, 13.6) years, and the majority of participants were women (62.2%). Participants with transportation trouble were more likely to report being disabled/unable to work (63.6%) and annual household income <$15 000 (45.5%). Mean TTR was significantly lower for participants with transportation trouble compared to those without (53.8% [SD, 24.7%] vs 64.7% [SD, 25.0%]; P = .03). Participants reporting transportation trouble or at least one transportation barrier were 1.60 (95% CI, 1.07‐2.39) and 1.68 (95% CI, 1.01‐2.80) times more likely, respectively, to have suboptimal AC compared to those without. Conclusion Inner‐city, low‐income individuals with transportation barriers were more likely to have suboptimal AC. Further research is warranted to evaluate the impact of alleviating patient‐specific transportation barriers on anticoagulation outcomes. |
| first_indexed | 2024-03-12T20:23:00Z |
| format | Article |
| id | doaj.art-00dd3eb674564710b228217295208005 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T20:23:00Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-00dd3eb674564710b2282172952080052023-08-02T00:42:00ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792021-10-0157n/an/a10.1002/rth2.12605Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort studyConnie H. Yan0Maryam Naveed1Ali Alobaidi2Miranda Kopfman3Edith A. Nutescu4Lisa K. Sharp5Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USADepartment of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USADepartment of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USADepartment of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USADepartment of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USADepartment of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USAAbstract Background Anticoagulation with warfarin represents a transportation‐sensitive treatment state. Transportation barrier is a common reason for not using health care services. Objective To assess the association between transportation barriers to anticoagulation clinic and anticoagulation control (AC) among an inner‐city, low‐income population. Patients/Methods Adults expected to be on chronic warfarin therapy were recruited from an ambulatory anticoagulation clinic. Participants completed a validated questionnaire that assessed transportation barriers to clinic, defined as self‐reported trouble getting transportation to a clinic and a composite score of the presence of transportation barriers. Suboptimal AC was defined as time in therapeutic range (TTR) <60% over 6 months. Prevalence ratios with 95% confidence intervals (CIs), adjusted for age, sex, and annual household income, described the association of transportation trouble and barriers with AC. Results Of 133 participants, 42.9% had suboptimal AC. Mean age was 60.4 (SD, 13.6) years, and the majority of participants were women (62.2%). Participants with transportation trouble were more likely to report being disabled/unable to work (63.6%) and annual household income <$15 000 (45.5%). Mean TTR was significantly lower for participants with transportation trouble compared to those without (53.8% [SD, 24.7%] vs 64.7% [SD, 25.0%]; P = .03). Participants reporting transportation trouble or at least one transportation barrier were 1.60 (95% CI, 1.07‐2.39) and 1.68 (95% CI, 1.01‐2.80) times more likely, respectively, to have suboptimal AC compared to those without. Conclusion Inner‐city, low‐income individuals with transportation barriers were more likely to have suboptimal AC. Further research is warranted to evaluate the impact of alleviating patient‐specific transportation barriers on anticoagulation outcomes.https://doi.org/10.1002/rth2.12605anticoagulantshealth outcomehealth care servicestransportationwarfarin |
| spellingShingle | Connie H. Yan Maryam Naveed Ali Alobaidi Miranda Kopfman Edith A. Nutescu Lisa K. Sharp Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study Research and Practice in Thrombosis and Haemostasis anticoagulants health outcome health care services transportation warfarin |
| title | Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study |
| title_full | Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study |
| title_fullStr | Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study |
| title_full_unstemmed | Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study |
| title_short | Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study |
| title_sort | association between transportation barriers and anticoagulation control among an inner city low income population a prospective observational cohort study |
| topic | anticoagulants health outcome health care services transportation warfarin |
| url | https://doi.org/10.1002/rth2.12605 |
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