title: Perceived barriers to clinic appointments for adolescents with sickle cell disease.
abstract: OBJECTIVE
  The purpose of this study was to examine perceived barriers to clinic attendance and strategies to overcome these barriers for adolescents with sickle cell disease.
  
  
  METHODS
  This was a 2-phased study, which used focus groups (n=13) and individual semistructured interviews (n=32) with adolescent patients (aged 13 to 21 y) from 3 pediatric sickle cell clinics in the Midwest.
  
  
  RESULTS
  Adolescents identified competing activities, health status, patient-provider relationships, adverse clinic experiences, and forgetting as barriers to clinic attendance. Calendars/reminders and parent reminders were the most commonly reported strategies to facilitate clinic attendance. Adolescents also reported the need for flexible scheduling and improved patient-provider communication.
  
  
  CONCLUSIONS
  Adolescents with sickle cell disease and their families may benefit from ongoing education about the importance of attending routine clinic visits. Adherence to clinic appointments for adolescents may be enhanced by developing interventions to decrease forgetting (eg, phone call reminders or text messaging) and increase patient satisfaction with clinic visits. Scheduling appointments to accommodate busy schedules/scheduling conflicts (eg, late clinic hours), providing teen-friendly clinic environments, and using technology may also facilitate attendance.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. lori.crosby@cchmc.org
authors.forename: Lori E
authors.initials: LE
authors.lastname: Crosby
authors.forename: Avani C
authors.initials: AC
authors.lastname: Modi
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Lemanek
authors.forename: Shanna M
authors.initials: SM
authors.lastname: Guilfoyle
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kalinyak
authors.forename: Monica J
authors.initials: MJ
authors.lastname: Mitchell
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000523:psychology* / Q000628:therapy; D001071:Appointments and Schedules; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D015146:Midwestern United States; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires