Exploring the impact of financial barriers on secondary prevention of heart disease

Abstract

BackgroundPatients with coronary artery disease experience various barriers which impact their ability to optimally manage their condition. Financial barriers may result in cost related non-adherence to medical therapies and recommendations, impacting patient health outcomes. Patient experiences regarding financial barriers remain poorly understood. Therefore, we used qualitative methods to explore the experience of financial barriers to care among patients with heart disease.MethodsWe conducted a qualitative descriptive study of participants in Alberta, Canada with heart disease (n = 13) who perceived financial barriers to care. We collected data using semi-structured face-to-face or telephone interviews inquiring about patients experience of financial barriers and the strategies used to cope with such barriers. Multiple analysts performed inductive thematic analysis and findings were bolstered by member checking.ResultsThe aspects of care to which participants perceived financial barriers included access to: medications, cardiac rehabilitation and exercise, psychological support, transportation and parking. Some participants demonstrated the ability to successfully self-advocate in order to effectively navigate within the healthcare and social service systems.ConclusionFinancial barriers impacted patients’ ability to self-manage their cardiovascular disease. Financial barriers contributed to non-adherence to essential medical therapies and health recommendations, which may lead to adverse patient outcomes. Given that it is such a key skill, enhancing patients’ self-advocacy and navigation skills may assist in improving patient health outcomes.

Incorporating intervention fidelity components into randomized controlled trials promoting exercise adherence in heart failure patients

“…It was particularly interesting to see that the paid membership was rated as the most helpful strategy. This is consistent with the literature reporting that access (e.g., finances, transportation, inclement weather) is a common barrier to routine exercise in HF patients (Barbour & Miller, ; Conraads et al, ; Cooper et al, ; Dhaliwal et al, ). The HR monitor, setting goals, education classes and coaching were all very close in ratings of helpfulness (8.43–8.82 on a 10‐point scale).…”

Medication non-adherence related to patients’ attitudes and knowledge rather than socio-cultural factors: a study of cardiac clinic attendees at a public healthcare institute

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“…The high cost of medications is frequently cited by CAD patients as a major driver of non-adherence [30, 31]. This likely explains why prescription drug coverage has previously and, in recent literature, continues to be positively associated with medication adherence.…”