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...

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Autores principales:	Connie H. Yan, Maryam Naveed, Ali Alobaidi, Miranda Kopfman, Edith A. Nutescu, Lisa K. Sharp
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	anticoagulants health outcome health care services transportation warfarin Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/00dd3eb674564710b228217295208005
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spelling	oai:doaj.org-article:00dd3eb674564710b2282172952080052021-11-29T09:35:28ZAssociation between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study2475-037910.1002/rth2.12605https://doaj.org/article/00dd3eb674564710b2282172952080052021-10-01T00:00:00Zhttps://doi.org/10.1002/rth2.12605https://doaj.org/toc/2475-0379Abstract 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.Connie H. YanMaryam NaveedAli AlobaidiMiranda KopfmanEdith A. NutescuLisa K. SharpWileyarticleanticoagulantshealth outcomehealth care servicestransportationwarfarinDiseases of the blood and blood-forming organsRC633-647.5ENResearch and Practice in Thrombosis and Haemostasis, Vol 5, Iss 7, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anticoagulants health outcome health care services transportation warfarin Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	anticoagulants health outcome health care services transportation warfarin Diseases of the blood and blood-forming organs RC633-647.5 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
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.
format	article
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
title	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_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_sort	association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: a prospective observational cohort study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/00dd3eb674564710b228217295208005
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Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study

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