title: Systemic lupus erythematosus observations of travel burden: A qualitative inquiry.
abstract: OBJECTIVE
  Explorations of travel impediments among patients suffering from rheumatic diseases have been very limited. Research has consistently indicated a shortage of rheumatologists, resulting in patients potentially having to travel long distances for care. The purpose of our study was to explore how systemic lupus erythematosus (SLE) patients experience travel issues differentially by race and socio-economic status.
  
  
  METHODS
  We conducted semi-structured interviews and a brief demographic survey with 10 patients diagnosed with SLE. Interview transcripts were coded and analyzed using NVivo Analysis Software to facilitate the reporting of recurrent themes and supporting quotations, and an initial codebook was independently developed by two researchers on the study team and then verified together.
  
  
  RESULTS
  Patients described three major areas of concern with respect to travel burden in accessing their rheumatologists: reliance on caregivers; meeting financial priorities; and pain and physical limitations.
  
  
  CONCLUSIONS
  Our data suggest general traveling challenges interfering with medical appointment compliance for several participants and the importance of socio-economic issues when considering travel issues. This study highlights an important area with implications for adherence to medical appointments and participation in research among patients with SLE.
authors.affiliation: Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Williams
authors.affiliation: Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Kasim
authors.initials: K
authors.lastname: Ortiz
authors.affiliation: Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Minnjuan
authors.initials: M
authors.lastname: Flournoy-Floyd
authors.affiliation: Office of Public Health Practice, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Bruner
authors.affiliation: Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Kamen
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers; D017281:Cost of Illness; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010349:Patient Compliance / Q000208:ethnology; D036301:Qualitative Research; D044469:Racial Groups; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D013022:South Carolina / Q000453:epidemiology; D014187:Transportation of Patients
keywords: access to care; systemic lupus erythematosus; travel burden