Barriers to medication use in rural underserved patients with asthma

Background: Asthma control is especially challenging for underserved populations. Medication use is critical to asthma control, but patients with asthma can experience barriers to using these medications. Objectives: To assess the nature, frequency and impact of barriers to medication use in rural underserved patients with asthma. Methods: A retrospective review of documentation from pharmacists' initial consultations with asthma patients was conducted. Pharmacist classified barriers in the following categories: knowledge, beliefs and practical issues. The Asthma Control Test (ACT) was used to assess disease control. Descriptive statistics and multivariate analyses were conducted. Results: Documentation from 46 consultations were examined. Eighteen participants (39%) had knowledge barriers, 18 (39%) had belief barriers and 16 (35%) had practical barriers. In bivariate analyses, only belief barriers were related to significantly worse asthma control (t = 1.83, P = 0.04). Adjusted analyses found that participants with both belief and practical barriers had significantly worse asthma control (beta = -3.44, P = 0.03) in comparison to others without both barriers. Conclusions: Barriers around medications beliefs were frequent and associated with worse asthma control. Programs that identify and tailor interventions to address these patient-specific barriers may improve outcomes in rural underserved patients with asthma. (C) 2015 Elsevier Inc. All rights reserved.