Department of Pharmacotherapy, University of Utah, 30 South, 2000 East, Rm #4323, Salt Lake City, UT, 84112-5820, USA.
Kantar LLC, San Francisco, CA, USA.
J Thromb Thrombolysis. 2019 Jul;48(1):35-41. doi: 10.1007/s11239-019-01880-3.
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.
静脉血栓栓塞症（VTE）是一个主要的医疗保健问题。医疗保健质量存在共同的障碍，但这些障碍对 VTE 患者是否相同？一项针对经历过近期 VTE 事件的成年人的全国在线调查。该调查评估了对 VTE 护理障碍的看法：（1）难以承担与 VTE 护理相关的医疗费用；（2）难以支付 VTE 处方药物的费用；（3）获得 VTE 护理的交通困难；（4）获得 VTE 护理所需的他人支持程度。每个问题都与患者的人口统计学特征相关，包括收入水平、居住地、当前工作状况和医疗保险；与 VTE 发作相关的护理相关伤害；一生中 VTE 事件的次数；对 VTE 结果的信念，以及口服抗凝剂治疗类型。逻辑回归分析用于确定独立变量对 VTE 护理障碍的影响。大约 30%的 VTE 患者报告至少存在一个 VTE 护理的重大障碍。患者认为医疗费用和 VTE 处方药物费用略有困难。在过去 2 年内经历 DVT 次数越多，报告障碍的几率就越高。VTE 相关的抑郁也与报告显著 VTE 护理障碍的几率增加呈中度相关。近 1/3 的 VTE 患者报告存在 VTE 护理的重大障碍，其中医疗费用和 VTE 药物费用是最常见的障碍。应尽早在护理中寻找可能遇到障碍的患者。
