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Understanding patients’ care barriers in the treatment of venous thromboembolism

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Abstract

Venous thromboembolism (VTE) is a major health care problem. There are common barriers to quality healthcare but are these barriers the same for VTE patients? A national online survey was administered to adults who had experienced a recent VTE event. The survey assessed perceptions of VTE care barriers: (1) Difficulty to meet healthcare costs related to VTE care; (2) difficulty to meet costs for VTE prescription medications; (3) difficulty with transportation to get VTE care; and (4) the degree of support of others needed to get VTE care. Each question was correlated with patient demographics including income level, place of residence, current work status, and health insurance; care related patient harms experienced with the VTE episode; number of lifetime VTE events; beliefs concerning VTE outcomes, and oral anticoagulant therapy type. Logistic regression analysis was used to determine the effect of independent variables on barriers to VTE care. Approximately 30% of VTE patients reported at least one significant barrier to VTE care. Patients rated healthcare costs and VTE prescription medication costs mildly difficult. The odds of reporting barriers were positively associated with the number of DVTs experienced in the previous 2 years. VTE-related depression was also moderately associated with increased odds of reporting significant VTE care barriers. Nearly 1 in 3 VTE sufferers reported significant barriers to VTE care, with healthcare costs and VTE medication costs being the most common. Efforts to identify patients who may experience barriers should be sought early in care.

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Funding

Pfizer Independent Grants for Learning and Change; Bristol-Myers-Squibb Independent Medical Education; and The Joint Commission.

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Authors and Affiliations

  1. Department of Pharmacotherapy, University of Utah, 30 South, 2000 East, Rm #4323, Salt Lake City, UT, 84112-5820, USA

    Timothy Pulleyn, Kibum Kim, Daniel M. Witt & Mark A. Munger

  2. Kantar LLC, San Francisco, CA, USA

    Michael Feehan

  3. Internal Medicine, University of Utah, Salt Lake City, UT, USA

    Mark A. Munger

Authors
  1. Timothy Pulleyn
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  2. Kibum Kim
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  4. Michael Feehan
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All authors fully contributed to the content of this manuscript, including meeting the four criteria of the Internal Committee of Medical Journal Editors. All authors had full access to all of the data in the study and take full responsibility for the integrity of the work and accuracy of the data analysis, from inception to published article.

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Correspondence to Daniel M. Witt.

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Dr. Feehan has consulted for Pfizer previously. The other authors have no conflicts of interest associated with the content of this manuscript.

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Pulleyn, T., Kim, K., Witt, D.M. et al. Understanding patients’ care barriers in the treatment of venous thromboembolism. J Thromb Thrombolysis 48, 35–41 (2019). https://doi.org/10.1007/s11239-019-01880-3

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  • DOI: https://doi.org/10.1007/s11239-019-01880-3

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