abstract: 'Background Anticoagulation with warfarin represents a

  transportation-sensitive treatment state. Transportation barrier is a

  common reason for not using health care services.

  Objective To assess the association between transportation barriers to

  anticoagulation clinic and anticoagulation control (AC) among an

  inner-city, low-income population.

  Patients/Methods Adults expected to be on chronic warfarin therapy were

  recruited from an ambulatory anticoagulation clinic. Participants

  completed a validated questionnaire that assessed transportation

  barriers to clinic, defined as self-reported trouble getting

  transportation to a clinic and a composite score of the presence of

  transportation barriers. Suboptimal AC was defined as time in

  therapeutic range (TTR) <60\% over 6 months. Prevalence ratios with 95\%

  confidence intervals (CIs), adjusted for age, sex, and annual household

  income, described the association of transportation trouble and barriers

  with AC.

  Results Of 133 participants, 42.9\% had suboptimal AC. Mean age was 60.4

  (SD, 13.6) years, and the majority of participants were women (62.2\%).

  Participants with transportation trouble were more likely to report

  being disabled/unable to work (63.6\%) and annual household income <\$15

  000 (45.5\%). Mean TTR was significantly lower for participants with

  transportation trouble compared to those without (53.8\% {[}SD, 24.7\%]

  vs 64.7\% {[}SD, 25.0\%]; P = .03). Participants reporting

  transportation trouble or at least one transportation barrier were 1.60

  (95\% CI, 1.07-2.39) and 1.68 (95\% CI, 1.01-2.80) times more likely,

  respectively, to have suboptimal AC compared to those without.

  Conclusion Inner-city, low-income individuals with transportation

  barriers were more likely to have suboptimal AC. Further research is

  warranted to evaluate the impact of alleviating patient-specific

  transportation barriers on anticoagulation outcomes.'
affiliation: 'Yan, CH (Corresponding Author), Univ Illinois, Dept Pharm Syst Outcomes
  \& Policy, 833 S Wood St,MC 871, Chicago, IL 60612 USA.

  Yan, Connie H.; Naveed, Maryam; Alobaidi, Ali; Kopfman, Miranda; Nutescu, Edith
  A.; Sharp, Lisa K., Univ Illinois, Coll Pharm, Dept Pharm Syst Outcomes \& Policy,
  Chicago, IL USA.

  Nutescu, Edith A.; Sharp, Lisa K., Univ Illinois, Ctr Pharmacoepidemiol \& Pharmacoecon
  Res, Chicago, IL USA.

  Nutescu, Edith A., Univ Illinois, Coll Pharm, Dept Pharm Practice, Chicago, IL USA.'
article-number: e12605
author: Yan, Connie H. and Naveed, Maryam and Alobaidi, Ali and Kopfman, Miranda and
  Nutescu, Edith A. and Sharp, Lisa K.
author-email: 'yan33@uic.edu

  aaloba3@uic.edu

  enutescu@uic.edu

  sharpl@uic.edu'
author_list:
- family: Yan
  given: Connie H.
- family: Naveed
  given: Maryam
- family: Alobaidi
  given: Ali
- family: Kopfman
  given: Miranda
- family: Nutescu
  given: Edith A.
- family: Sharp
  given: Lisa K.
da: '2023-09-28'
doi: 10.1002/rth2.12605
eissn: 2475-0379
files: []
journal: RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
keywords: 'anticoagulants; health outcome; health care services; transportation;

  warfarin'
keywords-plus: 'HEALTH-CARE; ORAL ANTICOAGULANT; UNITED-STATES; THERAPEUTIC RANGE;

  NATIONAL TRENDS; WARFARIN; TIME; INTERVENTIONS; VISITS; ACCESS'
language: English
month: OCT
number: '7'
number-of-cited-references: '41'
orcid-numbers: 'Yan, Connie/0000-0003-1467-4666

  Sharp, Lisa/0000-0002-7809-9042

  Nutescu, Edith/0000-0002-2651-0020'
papis_id: 40c00fb84111038b698d84668fd4c768
ref: Yan2021associationtransport
times-cited: '1'
title: 'Association between transportation barriers and anticoagulation control among
  an inner-city, low-income population: A prospective observational cohort study'
type: Article
unique-id: WOS:000727716100004
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '5'
web-of-science-categories: Hematology; Peripheral Vascular Disease
year: '2021'