title: Barriers to medication use in rural underserved patients with asthma.
abstract: 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.
  
  
  OBJECTIVE
  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 (β = -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.
authors.affiliation: Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, USA. Electronic address: hnyoung@uga.edu.
authors.forename: Henry N
authors.initials: HN
authors.lastname: Young
authors.affiliation: Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, USA.
authors.forename: Shada
authors.initials: S
authors.lastname: Kanchanasuwan
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Cox
authors.affiliation: Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Moreno
authors.affiliation: Family Health Center Pharmacy of Marshfield, Inc., Marshfield, WI, USA.
authors.forename: Nadra S
authors.initials: NS
authors.lastname: Havican
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration; D012189:Retrospective Studies; D012424:Rural Population; D035862:Vulnerable Populations
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Asthma; Medication use; Rural; Underserved