African-Americans (AA) have a higher rate of morbidity and mortality than Caucasians. There have been studies on barriers to asthma care in AA populations, but there has never been a study including other groups involved in asthma care.
In this qualitative study, focus groups of AA with  asthma (separate male and female groups),  care-givers of those with asthma, and  providers of asthma care were conducted to explore the barriers to care in AA with asthma. Focus groups of AA were conducted using a standardized questionnaire and moderator. A pulmonologist was present during all focus group sessions. Focus groups were conducted until saturation of themes was obtained.
Some of the emerging themes are:  cost of care and medications, lack of insurance, lack of paid sick time,  lack of knowledge of the disease and its treatment,  lack of symptom awareness and how to describe these symptoms to health-care providers,  apathy and indifference to their asthma (especially if the disease was long-standing), and  fear of the disease and its treatment (particularly as involves inhaled steroids due to the negative connotations of the word “steroid”).
This study provides insight into barriers to successful asthma care in a small sample of multiple groups involved in asthma care in AA. Many of these barriers involve socio-economic status of the patients, but an emerging theme is that perception of severity and symptomology were highly variable in this group. Fear of treatment among asthmatics and their care-givers also emerged as an important theme.
No changes in treatment guidelines have successfully addressed these barriers to care, potentially resulting in under-treatment of this vulnerable population.
David Trochtenberg, No Financial Disclosure Information; No Product/Research Disclosure Information