title: Why do older adult women fall short of the recommended follow-up care for coronary artery disease?
abstract: BACKGROUND
  Many women with coronary artery disease (CAD), commonly referred to as coronary heart disease, do not receive an annual office visit to manage their disease. We set out to determine what barriers factor into women not receiving an office visit to manage their disease.
  
  
  METHODS
  A purposive sample of 26 eligible women (≥65 years of age) diagnosed with CAD completed in-depth, qualitative interviews. Systematic analysis of the content of interviews was performed on transcripts from these interviews. Participants with an AARP Medicare Supplement Insurance Plan insured by UnitedHealthcare insurance company that did not receive an annual office visit were eligible. In addition, we surveyed 100 physicians to obtain their thoughts about why women may not schedule at least one annual visit to manage their CAD.
  
  
  RESULTS
  The most common barriers identified were skepticism of heart problems, having to take the initiative to schedule the appointment, and dealing with seemingly more pressing health problems. Many of these barriers identified were substantiated in a survey of physicians that treat women with CAD, but the relative rankings of the importance of these problems differed somewhat.
  
  
  CONCLUSIONS
  Many women were skeptical about their heart health and often lacked the initiative to schedule a follow-up appointment. Most agreed that they would make an appointment if contacted by their doctor's office. Many of these women were receptive to the idea of receiving educational information by mail. Active involvement by doctors' offices to schedule appointments may help improve care, as might mail-based reminders.
authors: OptumHealth Care Solutions, Ann Arbor, MI 48108, USA. Ronald.Ozminkowski@optum.com
authors: Ronald J
authors: RJ
authors: Ozminkowski
authors: Frank G
authors: FG
authors: Bottone
authors: Nancy
authors: N
authors: Dodd
authors: Meg
authors: M
authors: Lamm
authors: Andrea
authors: A
authors: Levy
authors: Karen
authors: K
authors: Valerio
authors: Cynthia
authors: C
authors: Barnowski
authors: Tod
authors: T
authors: O'Donovan
authors: Michelle
authors: M
authors: Legros
authors: Kevin
authors: K
authors: Hawkins
authors: Janelle G
authors: JG
authors: Ekness
authors: Richard J
authors: RJ
authors: Migliori
authors: Charlotte S
authors: CS
authors: Yeh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D001294:Attitude to Health; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D006278:Medicare; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010820:Physicians; D036301:Qualitative Research; D012720:Severity of Illness Index; D013689:Telephone; D014481:United States