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Arizpe A, Navarro S, Ochoa-Dominguez CY, Rodriguez C, Kim SE, Farias AJ. Nativity differences in socioeconomic barriers and healthcare delays among cancer survivors in the All of Us cohort. Cancer Causes Control 2024; 35:203-214. [PMID: 37679534 PMCID: PMC10787892 DOI: 10.1007/s10552-023-01782-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE We aimed to assess whether nativity differences in socioeconomic (SES) barriers and health literacy were associated with healthcare delays among US cancer survivors. METHODS "All of Us" survey data were analyzed among adult participants ever diagnosed with cancer. A binary measure of healthcare delay (1+ delays versus no delays) was created. Health literacy was assessed using the Brief Health Literacy Screen. A composite measure of SES barriers (education, employment, housing, income, and insurance statuses) was created as 0, 1, 2, or 3+. Multivariable logistic regression model tested the associations of (1) SES barriers and health literacy with healthcare delays, and (2) whether nativity modified this relationship. RESULTS Median participant age was 64 years (n = 10,020), with 8% foreign-born and 18% ethnic minorities. Compared to survivors with no SES barriers, those with 3+ had higher likelihood of experiencing healthcare delays (OR 2.18, 95% CI 1.84, 2.58). For every additional barrier, the odds of healthcare delays were greater among foreign-born (1.72, 1.43, 2.08) than US-born (1.27, 1.21, 1.34). For every 1-unit increase in health literacy among US-born, the odds of healthcare delay decreased by 9% (0.91, 0.89, 0.94). CONCLUSION We found that SES barriers to healthcare delays have a greater impact among foreign-born than US-born cancer survivors. Higher health literacy may mitigate healthcare delays among US cancer survivors. Healthcare providers, systems and policymakers should assess and address social determinants of health and promote health literacy as a way to minimize healthcare delays among both foreign- and US-born cancer survivors.
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Affiliation(s)
- Angel Arizpe
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA
| | - Stephanie Navarro
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA
| | | | | | - Sue E Kim
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA
| | - Albert J Farias
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA.
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MacDonald M, Mirza AS, Mhaskar R, Ewing A, Chen L, Robinson K, Lu Y, Ayoubi N, Gonzalez E, Guerra L, Roetzheim R, Woodard L, Pabbathi S. Preventative Cancer Screening Rates Among Uninsured Patients in Free Clinics: A Retrospective Cohort Study of Cancer Survivors and Non-cancer Survivors. Cancer Control 2022; 29:10732748211072983. [PMID: 35245986 PMCID: PMC8902193 DOI: 10.1177/10732748211072983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background There is limited research on screening rates among uninsured cancer
survivors. Uninsured cancer survivors are at higher risk of poorer health
outcomes than the insured due to limited access to preventative screening
for secondary cancers. This study examines the rates of surveillance and
screening of uninsured cancer survivors and compares to uninsured patients
without a cancer history seen in free clinics. Methods Data were collected retrospectively from electronic medical records and paper
charts of patients from 10 free clinics between January 2016 and December
2018 in the Tampa Bay area. The prevalence of socioeconomic characteristics,
cancer diagnoses, and screening practices were compared for cancer survivors
and free clinic patients without a history of cancer. Study participants
were determined to be eligible for cancer screenings based on the United
States Preventive Services Task Force guidelines. Results Out of 13 982 uninsured patients frequenting free clinics between 2016 and
2018, 402 (2.9%) had a documented history of cancer. Out of the 285 eligible
cancer survivors, 44 (15.4%) had completed age-appropriate colon cancer
screening. Among the 170 female cancer survivors, 75 (44.1%) had completed
breast cancer screenings, and only 5.9% (59/246) had completed cervical
cancer screenings. After adjusting for age, gender, race, salary, employment
status, and household size, cancer survivors were more likely to undergo
colorectal cancer screening (OR: 3.59, 95% CI: 2.10–6.15) and breast cancer
screening (OR: 2.13, 95% CI: 1.30–3.84) than patients without a cancer
history. This difference was not seen for cervical cancer screening (OR:
0.99, 95% CI: .62–1.58). Conclusions Uninsured cancer survivors frequenting free clinics represent a unique
population that is underrepresented in the medical literature. Our results
suggest that uninsured survivors use screening services at higher rates when
compared to uninsured patients without a reported cancer diagnosis. However,
these rates are suboptimal when compared to national screening rates of
insured cancer survivors.
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Affiliation(s)
- Madeline MacDonald
- 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Abu-Sayeef Mirza
- Department of Internal Medicine, 7831University of South Florida, Tampa, FL, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, 7831University of South Florida, Tampa, FL, USA
| | - Aldenise Ewing
- Health Outcomes and Behavior, 5301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Liwei Chen
- Department of Medical Education, 7831University of South Florida, Tampa, FL, USA
| | - Katherine Robinson
- Department of Internal Medicine, 7831University of South Florida, Tampa, FL, USA
| | - Yuanyuan Lu
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Noura Ayoubi
- 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Eduardo Gonzalez
- Department of Family Medicine, 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Lucy Guerra
- Department of Internal Medicine, 7831University of South Florida, Tampa, FL, USA
| | - Richard Roetzheim
- Department of Medical Education, 7831University of South Florida, Tampa, FL, USA.,Department of Family Medicine, 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Laurie Woodard
- Department of Medical Education, 7831University of South Florida, Tampa, FL, USA.,Department of Family Medicine, 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Smitha Pabbathi
- Survivorship Clinic, 25301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Fitzpatrick OM, Murphy C, Duignan E, Egan K, Hennessy BT, Grogan L, Murphy A, Breathnach OS, Naidoo J, Morris PG. The cost of cancer care: how far would you go for a trial? Ir J Med Sci 2022; 191:2487-91. [PMID: 35038110 DOI: 10.1007/s11845-021-02915-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Clinical trials are often considered the gold standard in cancer care. However, patients face barriers in trial participation including distances to cancer centres and personal costs including changing employment status, cost of medications, inpatient admissions, and parking tariffs. AIM Our aim was to compare the distances patients travelled for clinical trials compared to those receiving standard systemic anticancer therapy (SACT). We also investigated the additional costs associated with this. METHODS This was a retrospective review of electronic patient medical records. The distance from the patients' home address to Beaumont was calculated as a one-way journey in kilometres. Patients attending for clinical trials were compared to those receiving standard of care SACT. RESULTS A total of 271 patients receiving standard SACT over a 5-day period and 111 patients enrolled on 24 clinical trials were included. The median one-way distance travelled by patients enrolled in clinical trials was 41.4 km, compared to 14 km in those patients' receiving standard of care SACT. The median estimated cost was €13 vs €4.20 for those enrolled on clinical trials compared to those receiving standard of care treatment, respectively. CONCLUSION Patients enrolled on clinical trials often travel more than twice as far to receive their anti-cancer treatment compared to those receiving standard of care SACT and incur an increased cost of travel expenses.
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Lu ZK, Xiong X, Brown J, Horras A, Yuan J, Li M. Impact of Cost-Related Medication Nonadherence on Economic Burdens, Productivity Loss, and Functional Abilities: Management of Cancer Survivors in Medicare. Front Pharmacol 2021; 12:706289. [PMID: 34267667 PMCID: PMC8276034 DOI: 10.3389/fphar.2021.706289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Cancer survivors are vulnerable to have medication nonadherence. We aimed to estimate the impact of cost-related medication nonadherence on economic burdens, productivity loss, and functional abilities among cancer survivors. Methods: A cross-sectional study was conducted using data from the National Health Interview Survey (NHIS), 2011–2018. Cost-related medication nonadherence was identified based on NHIS prompts. An ordinal logistic regression model was used to determine the impact of cost-related medication nonadherence on survivors’ economic burden. Two negative binomial regression models were implemented to estimate the impact on productivity loss. In addition, four logistic regression models were used to determine the impact on functional abilities. The weighted analysis was used to generate national estimates. Results: Among 35, 773, 286 cancer survivors, 15, 002, 192 (41.9%) respondents reported that they experienced cost-related medication nonadherence. Compared to cancer survivors without cost-related medication nonadherence, those with nonadherence were significantly associated with an increased economic burden (OR: 1.89, 95% CI: 1.70–2.11). Also, cancer survivors with cost-related medication nonadherence were significantly more likely to have an increased bed disability day (IRR: 1.46, 95% CI: 1.21–1.76). In terms of the limitations, cancer survivors with nonadherence were significantly more likely to have both activity limitation (OR: 1.42, 95% CI: 1.25–1.60) and functional limitation (OR: 2.12, 95% CI: 1.81–2.49). Conclusion: Cost-related medication nonadherence increased economic burdens, productivity loss, and limitations in functional abilities among cancer survivors. Strategies are needed to help cancer survivors with cost-related medication nonadherence to be adherent to prescriptions.
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Affiliation(s)
- Z Kevin Lu
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Xiaomo Xiong
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Jacob Brown
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Ashley Horras
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Jing Yuan
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai, China
| | - Minghui Li
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN, United States
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MacDonald MR, Zarriello S, Swanson J, Ayoubi N, Mhaskar R, Mirza AS. Secondary prevention among uninsured stroke patients: A free clinic study. SAGE Open Med 2020; 8:2050312120965325. [PMID: 33110604 PMCID: PMC7564623 DOI: 10.1177/2050312120965325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 09/18/2020] [Indexed: 01/03/2023] Open
Abstract
Objectives: Free clinics manage a diversity of diseases among the uninsured. We sought to assess the medical management of stroke in a population of uninsured patients. Methods: A retrospective chart review was conducted to collect chronic disease statistics from 6558 electronic medical records and paper charts at nine free clinics in Tampa, Florida, from January 2016 to December 2017. Demographics and risk factors were compared between stroke patients and non-stroke patients. Medication rates for several comorbidities were also assessed. Results: Two percent (107) of patients had been diagnosed with a stroke. Stroke patients were older (mean (M) = 56.0, standard deviation (SD) = 11.2) than the rest of the sample (M = 43.3, SD = 15.4), p < 0.001 and a majority were men (n = 62, 58%). Of the stroke patients with hypertension (n = 79), 81% (n = 64) were receiving anti-hypertensive medications. Of the stroke patients with diabetes (n = 43), 72% (n = 31) were receiving diabetes medications. Among all stroke patients, 44% were receiving aspirin therapy (n = 47). Similarly, 39% of all stroke patients (n = 42) were taking statins. Conclusions: Uninsured patients with a history of stroke may not be receiving adequate secondary prevention highlighting the risk and vulnerability of uninsured patients. This finding identifies an area for improvement in secondary stroke prevention in free clinics.
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Affiliation(s)
| | - Sydney Zarriello
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Justin Swanson
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Noura Ayoubi
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Rahul Mhaskar
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA.,Department of Internal Medicine, University of South Florida, Tampa, FL, USA
| | - Abu-Sayeef Mirza
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA.,Department of Internal Medicine, University of South Florida, Tampa, FL, USA
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MacDonald M, Shah S, Swanson J, Song E, Ahsan T, Pabbathi S, Mhaskar R, Mirza AS. Substance Use in Uninsured Cancer Survivors: A Multicenter Cross-Sectional Study of Free Clinics. Cureus 2020; 12:e10083. [PMID: 33005507 PMCID: PMC7522175 DOI: 10.7759/cureus.10083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Substance use disorders occur in about 5% of the cancer population and can decrease treatment adherence, impede pain management, and undermine a cancer survivor’s network of social support. Although current literature demonstrates substance use is associated with socioeconomic disparity, there is limited research on the prevalence of alcohol, tobacco, and illicit drug use among uninsured cancer survivors in the United States. Our multicenter cross-sectional study describes the prevalence of substance use in uninsured cancer survivors in the Tampa Bay Area. Methods A comprehensive retrospective chart review of electronic medical records and paper charts was conducted at nine free clinics in the Tampa Bay Area of Florida between January 1, 2016, and December 31, 2017. Substance use prevalence was compared between uninsured cancer survivors and uninsured patients without reported cancer history after adjusting for available demographic risk factors. Results There were 222 patients with a history of cancer and 6,768 patients without a history of cancer included for analysis. Cancer survivors had a median age of 55 years (interquartile range 48-61 years), were mostly female (n = 146, 66.1%), and of Hispanic ethnicity (n = 94, 52.5%). Cancer survivors were more likely to be current smokers (n = 42, 25.1%) compared to patients without a cancer history (n = 759, 16.1%). Patients with a history of cancer were more likely to be current drinkers (n = 34, 26%) compared to non-cancer patients (n = 942, 22.9%). There was no significant difference in illicit drug use history between the two groups. Conclusions Our study demonstrates that uninsured cancer survivors are more likely to be smokers and alcohol consumers than uninsured patients without a history of cancer. There was no significant difference in illicit drug use in cancer survivors and patients without a history of cancer. Future educational interventions should target substance use among uninsured cancer survivors.
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Affiliation(s)
- Madeline MacDonald
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Shreni Shah
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Justin Swanson
- College of Public Health, University of South Florida, Tampa, USA
| | - Ethan Song
- Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Tanzila Ahsan
- College of Arts and Sciences, University of South Florida, Tampa, USA
| | - Smitha Pabbathi
- Internal Medicine, Moffitt Cancer Center Department of Internal Medicine, Tampa, USA
| | - Rahul Mhaskar
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Abu-Sayeef Mirza
- Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
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7
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Molto A, Gossec L, Poiraudeau S, Claudepierre P, Soubrier M, Fayet F, Wendling D, Gaudin P, Dernis E, Guis S, Pouplin S, Ruyssen A, Chales G, Mariette X, Beauvais C, Combe B, Flipo RM, Richette P, Chary-Valckenaere I, Saraux A, Sibilia J, Schaeverbeke T, Dougados M. Evaluation of the impact of a nurse-led program of systematic screening of comorbidities in patients with axial spondyloarthritis: The results of the COMEDSPA prospective, controlled, one year randomized trial. Semin Arthritis Rheum 2020; 50:701-708. [PMID: 32521324 DOI: 10.1016/j.semarthrit.2020.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the impact of a nurse-led program of systematic screening for the management (detection/prevention) of comorbidities. METHODS Prospective, randomized, controlled, open, 12-month trial (NCT02374749). PARTICIPANTS consecutive patients with axial Spondyloarthritis (axSpA) (according to the rheumatologist) THE PROGRAM: A nurse collected data on comorbidities during a specific outpatient visit. In the event of non-agreement with recommendations, the patient was informed and a specific recommendation was given to the patient (orally and in a with a detailed written report). Patients were seen after one year in a nurse-led visit. TREATMENT ALLOCATION: random allocation (i.e. either this program or an educational program not presented here and considered here as the control group). MAIN OUTCOME change after one year of a weighted comorbidity management score (0 to 100 where 0= optimal management). RESULTS 502 patients were included (252 and 250 in the active and control groups, respectively): age: 47±12 years, male gender: 63%, disease duration: 14±11y. After one year, no differences were observed in a weighted comorbidity management score. However, the number of patients in agreement with recommendations was significantly higher in the active group for vaccinations (flu vaccination: 28.6% vs. 9.9%, p<0.01; pneumococcal vaccination:40.0% vs. 21.1%,p=0.04), for cancer screening (skin cancer screening: 36.3% vs. 17.2%, p=0.04) and for osteoporosis (bone densitometry performed: 22.6% vs. 8.7%, p<0.01; Vitamin D supplementation initiation: 51.9% vs. 9.4%, p<0.01). CONCLUSIONS AND RELEVANCE This study suggests the short-term benefit of a single-visit nurse-led program for systematic screening of comorbidities for its management in agreement with recommendations, even in this young population of patients with axSpA.
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Affiliation(s)
- Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Université de Paris, INSERM U-1153, CRESS, Paris, France.
| | - Laure Gossec
- Sorbonne Université, IPLESP, INSERM, Paris France; Pitié Salpêtrière hospital, APHP, Rheumatology department, Paris, France
| | - Serge Poiraudeau
- Rehabilitation and Physical Medicine Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pascal Claudepierre
- Rheumatology Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, and Université Paris Est Créteil, EA, 7379 - EpidermE, F-94010, Créteil, France
| | - Martin Soubrier
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Françoise Fayet
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Daniel Wendling
- Rheumatology Department, CHRU de BESANCON, University Teaching Hospital, and Université Bourgogne Franche-Comté, EA4266 (EPILAB), Besançon, France
| | | | | | | | | | - Adeline Ruyssen
- Centre de Rhumatologie, Hôpital Purpan, Toulouse, et Faculté de Médecine, Université Toulouse III, Paul Sabatier University, Toulouse, France
| | - Gerard Chales
- Medecine Faculty, Department of Rheumatology, South Hospital, Rennes 1 University, Rennes, France
| | - Xavier Mariette
- Rheumatology Department, APHP, Bicêtre Hospital, Le Kremlin-Bicetre, France
| | | | - Bernard Combe
- Rheumatology department, CHU Montpellier, Montpellier University, Montpellier, France
| | - René-Marc Flipo
- Rheumatology Department, CHU Roger Salengro Hospital, University of Lille, Lille, France
| | - Pascal Richette
- Université Paris Diderot, UFR médicale, Paris, France; APHP Hôpital Lariboisiére, Fédération de Rhumatologie, Paris, France
| | | | - Alain Saraux
- Rheumatology Unit, UMR1227 (Lymphocytes B et Autoimmunité), Université de Brest, Inserm, CHU Brest, LabEx IGO, Brest, France
| | - Jean Sibilia
- Department of Rheumatology, Hautepierre CHU, Fédération de médecine translationnelle, UMR INSERM 1109, Strasbourg, France
| | | | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Université de Paris, INSERM U-1153, CRESS, Paris, France
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Mirza AS, Chen L, Amirzadeh S, Majethia S, Joppen J, Mirza S, Mhaskar R, Jaglal M, Ashraf N. Health disparities and chronic disease associated with anemia in free clinics: A retrospective study of uninsured patients in Tampa Bay. Postgrad Med 2019; 131:612-618. [PMID: 31524033 DOI: 10.1080/00325481.2019.1668241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: The objective of this study was to assess the diagnosis and management of anemic patients in free clinics around the Tampa Bay area.Methods: In this retrospective study we extracted data including demographics, chronic diseases, and laboratory values from medical charts of uninsured patients seen in 9 free clinics from January 2016 through December 2017 in the Tampa Bay area, FL, USA. Multiple logistic regression analysis was used to assess relationships between socioeconomic variables and a documented history of anemia.Results: From two years of documented data, 6971 patients were included, of which 367 (5%) had a documented diagnosis of anemia. Most were women (315, 86%), and the median age was 41 years (6-91). Among the 367 patients with anemia,191 (52%) patients had an unspecified type of anemia, 144 (39%) were diagnosed with IDA, 16 (4%) with anemia of chronic disease, and the remaining were other uncommon causes. Only 67% (97/144) of IDA patients had documented iron replacement. Colonoscopies were documented in only 32 (9%) of all patients with anemia, and in 23 (16%) IDA patients. Several chronic diseases were statistically associated and comorbid with a diagnosis of anemia.Conclusions: Uninsured patients with IDA are prescribed iron and undergo colonoscopies at sub-optimal rates. Increasing resources, awareness, and education of providers in these settings could lead to improved treatment practices and decrease the risk of morbidity and mortality.
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Affiliation(s)
- Abu-Sayeef Mirza
- Department of Internal Medicine, University of South Florida, Tampa, USA
| | - Liwei Chen
- Evidenced Based Medicine, University of South Florida, Tampa, USA
| | - Sean Amirzadeh
- Department of Internal Medicine, University of South Florida, Tampa, USA
| | - Saagar Majethia
- College of Arts and Sciences, University of South Florida, Tampa, USA
| | - Jeffrey Joppen
- College of Arts and Sciences, University of South Florida, Tampa, USA
| | - Sabbir Mirza
- College of Arts and Sciences, University of South Florida, Tampa, USA
| | - Rahul Mhaskar
- Evidenced Based Medicine, University of South Florida, Tampa, USA
| | - Michael Jaglal
- Department of Hematology and Oncology, University of South Florida, Tampa, USA
| | - Noman Ashraf
- Department of Hematology and Oncology, University of South Florida, Tampa, USA
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