Barriers to Treatment

ObjectivesIndividuals with heterozygous familial hypercholesterolaemia (FH) are at high risk of developing cardiovascular disease (CVD). This risk can be substantially reduced with lifelong pharmacological and lifestyle treatment; however, research suggests adherence is poor. We synthesised the qualitative research to identify enablers and barriers to treatment adherence.DesignThis study conducted a thematic synthesis of qualitative studies.Data sourcesMEDLINE, Embase, PsycINFO via OVID, Cochrane library and CINAHL databases and grey literature sources were searched through September 2018.Eligibility criteriaWe included studies conducted in individuals with FH, and their family members, which reported primary qualitative data regarding their experiences of and beliefs about their condition and its treatment.Data extraction and synthesisQuality assessment was undertaken using the Critical Appraisal Skills Programme for qualitative studies. A thematic synthesis was conducted to uncover descriptive and generate analytical themes. These findings were then used to identify enablers and barriers to treatment adherence for application in clinical practice.Results24 papers reporting the findings of 15 population samples (264 individuals with FH and 13 of their family members) across 8 countries were included. Data captured within 20 descriptive themes were considered in relation to treatment adherence and 6 analytical themes were generated: risk assessment; perceived personal control of health; disease identity; family influence; informed decision-making; and incorporating treatment into daily life. These findings were used to identify seven enablers (eg, ‘commencement of treatment from a young age’) and six barriers (eg, ‘incorrect and/or inadequate knowledge of treatment advice’) to treatment adherence. There were insufficient data to explore if the findings differed between adults and children.ConclusionsThe findings reveal several enablers and barriers to treatment adherence in individuals with FH. These could be used in clinical practice to facilitate optimal adherence to lifelong treatment thereby minimising the risk of CVD in this vulnerable population.PROSPERO registration numberCRD42018085946.

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Firefighters, posttraumatic stress disorder, and barriers to treatment: Results from a nationwide total population survey

PLoS ONE ◽

10.1371/journal.pone.0190630 ◽

2018 ◽

Vol 13 (1) ◽

pp. e0190630 ◽

Cited By ~ 22

Author(s):

Jieun E. Kim ◽

Stephen R. Dager ◽

Hyeonseok S. Jeong ◽

Jiyoung Ma ◽

Shinwon Park ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Population Survey ◽

Total Population ◽

Stress Disorder ◽

Barriers To Treatment ◽

Treatment Results

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Current Management and Barriers to Treatment for Wet Age-Related Macular Degeneration (Wamd): Perspectives From Patients and Caregivers

Value in Health ◽

10.1016/j.jval.2014.08.2146 ◽

2014 ◽

Vol 17 (7) ◽

pp. A612

Author(s):

M. Varano ◽

N. Eter ◽

S. Winyard ◽

K.U. Wittrup-Jensen ◽

J Heraghty

Keyword(s):

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Barriers To Treatment ◽

Current Management ◽

Age Related

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Treatment utilization and barriers to treatment engagement among people with body dysmorphic symptoms

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2010.10.002 ◽

2011 ◽

Vol 70 (3) ◽

pp. 286-293 ◽

Cited By ~ 49

Author(s):

Luana Marques ◽

Hilary M. Weingarden ◽

Nicole J. LeBlanc ◽

Sabine Wilhelm

Keyword(s):

Treatment Engagement ◽

Treatment Utilization ◽

Barriers To Treatment

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Development of an Instrument to Identify Barriers to Treatment for Addicted Women, from Their Perspective

International Journal of the Addictions ◽

10.3109/10826089409047391 ◽

1994 ◽

Vol 29 (4) ◽

pp. 429-444 ◽

Cited By ~ 24

Author(s):

Karen Allen

Keyword(s):

Barriers To Treatment

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Impact of Voice and Swallowing Problems in the Elderly

Otolaryngology ◽

10.1016/j.otohns.2008.05.162 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P50-P50

Author(s):

Richard Turley ◽

Seth M Cohen

Keyword(s):

Quality Of Life ◽

Treatment Options ◽

The Elderly ◽

T Test ◽

Barriers To Treatment ◽

Continuous Variables ◽

Spearman Correlation ◽

Cross Sectional ◽

Swallowing Problems

Objective 1) Evaluate the prevalence of and quality of life impact of voice and swallowing problems in the elderly. 2) Determine treatment trends and barriers to treatment. Methods Cross-sectional study of independent living residents in 2 retirement communities. Main outcome measures include prevalence of dysphonia and dysphagia, Voice Related Quality of Life (VRQOL), 7-point Likert scale of dysphagia severity, Center for Epidemiologic Studies Depression (CES-D) scale, and barriers to treatment. Relationship between continuous variables were analyzed with Spearman correlation and between categorical and continuous variables with a t-test. Results 248 residents responded, with a mean age of 82.4 years. 19.8% had dysphonia, 13.7% dysphagia, and 6% both. Respondents with more severe swallowing difficulty had greater impairment on the VRQOL (p = 0.04, Spearman correlation = −0.4). Respondents with both dysphonia and dysphagia had greater depression scores than those with neither symptom (mean CES-D score 15.5 versus 9.9, p = 0.008, t-test). While 75% of respondents with dysphonia were interested in treatment, only 20.4% and 2.1% had sought treatment for dysphonia and dysphagia, respectively. Being unaware of treatment options, and viewing voice and swallowing trouble as a normal part of aging, were the two most common reasons for not seeking treatment. Conclusions Voice and swallowing problems are common in the elderly but they are not realizing potential treatment benefits. Improved health care services for voice and swallowing problems in the elderly are essential.

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