Patients' Perspectives of Factors That Support the Management of Peripheral Arterial Disease for Improved Outcomes

A Study of Patients' Perspectives of Factors That Support the Management of Cardiac Care for Improved Outcomes in a Peripheral Arterial Disease Population

Specific Aims: To delve into the complex phenomena of living with Peripheral Arterial Disease (PAD), and to investigate the patients' perspective of the factors that affects their decisions regarding management of their PAD.

a) Utilize a qualitative approach to uncover factors that patients perceive support the management of their condition utilizing a purposive sampling of Peripheral Arterial Disease patients.

1. To determine what they believe to be effective tools to support themselves to improve their condition.
2. To determine from the patient's perspective if adherence to prescribed medical regimes are important for them to improve their PAD outcomes.
3. To describe the patient factors of those who are self reported adherent compared to those who are not or unable to their prescribed regimen.

Study Overview

• Status: Completed
• Conditions: Peripheral Arterial Diseases

Detailed Description

Cardiovascular Diseases (CVD) affects as many lives each year as cancer, chronic lower respiratory diseases, accidents and diabetes mellitus combined. One in three American adults (about 80,000,000) has one or more types of cardiovascular disease. Prevention and management of CVD is a public health goal, yet, it remains a major challenge. Even hypertension, which is easily detected and usually controllable, has only a 50 percent control rate.

Peripheral Arterial Disease (PAD) is one type of CVD, which affects about eight million Americans and is also associated with significant morbidity and mortality. PAD increases with age and disproportionately affects African Americans. Interestingly, despite its prevalence and cardiovascular risk implications, only 20 to 30 percent of PAD patients are undergoing treatment.

Medical management of these diseases has substantially contributed to improved morbidity and mortality. However, for the medical therapies to be successful the patients need to take their medications and adjust their lifestyles, as prescribed. Overall, "typical adherence rates for the general population are about 50 percent for medications and are much lower for lifestyle prescriptions and other more behaviorally demanding regimens". Few studies have investigated the reactions and thoughts regarding the efficacy of therapies/interventions from the perspective of the participants. Meta analyses on adherence have also revealed that the patients' perspectives are often absent and that present adherence theories are more successful in explaining non-adherence than improving adherence. Therefore, it is important to understand, from the perspective of the patient; the factors they believe improve their cardiac outcomes with an emphasis on the adherence to prescribed therapies.

This qualitative study will investigate the question: What are patients' perspectives of factors that support the management of their cardiovascular condition to improve outcomes in a Peripheral Arterial Disease population? Cardiac outcomes of interest are health status defined by symptom burden, functional status, and health related quality of life, patients' perception of the quality of care that they receive, and the experience of living with PAD.

• Study Type: Observational
• Enrollment (Actual): 10

Contacts and Locations

Study Locations

• United States
  • Colorado
    • Denver, Colorado, United States, 80220
      • VA ECHCS

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 89 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A purposive sampling technique, meaning the sample will be selected according to the participant's diagnosis of the specific disease, will be utilized to enroll up to 24 Peripheral Arterial Disease patients from the VA Peripheral Arterial Disease clinic.

Description

Inclusion Criteria:

Diagnosis of Peripheral Arterial Disease

Exclusion Criteria:

Unable to converse about the topic under investigation for up to one hour for multiple visits

Pregnancy

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Peripheral Arterial Disease (PAD); This is a longitudinal observational study. There were no interventions administered.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patients' perspective of the factors that affects their decisions regarding management of their PAD	Qualitative interview that will collect patients perspectives and will be analyzed for thoughts, opinions, feelings, and concepts.	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quantitative Morinsky's Medication adherence survey	Morinsky's Medication adherence survey will be administered at baseline and one year to assess self report medication adherence.	1 year
Quantitative PAQ health status survey	PAQ health status will be administered at the initial visit as well as the last one-on-one interview to assess disease specific health status.	1 year
Quantitative EQ-5D health status survey	survey will be administered at the initial visit as well as the last one-on-one interview to assess overall health status.	1 year
Quantitative Stage of Change Survey	Stage of Change motivational survey will be administered at the initial visit as well as the last one-on-one interview to assess patients motivational status.	1 year
Quantitative SEAMS survey	SEAMS self efficacy survey will be administered at the initial visit as well as the last one-on-one interview to assess patient self efficacy to adhere to medication treatment.	1 year

Collaborators and Investigators

• Sponsor: VA Eastern Colorado Health Care System
• Investigators: Principal Investigator: Anne C Lambert-Kerzner, PhD, MSPH, VAMC in Denver, Co.; Study Director: Thomas Tsai, MD, VAMC Denver, Co.

Study record dates

Study Major Dates

• Study Start: January 1, 2011
• Primary Completion (ACTUAL): December 1, 2016
• Study Completion (ACTUAL): December 1, 2016

Study Registration Dates

• First Submitted: April 11, 2011
• First Submitted That Met QC Criteria: August 17, 2011
• First Posted (ESTIMATE): August 18, 2011

Study Record Updates

• Last Update Posted (ACTUAL): May 23, 2017
• Last Update Submitted That Met QC Criteria: May 22, 2017
• Last Verified: May 1, 2017

More Information

Terms related to this study

• Keywords: Peripheral Arterial Disease (PAD); Qualitative analysis; Patients' perspective
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Atherosclerosis; Peripheral Arterial Disease; Peripheral Vascular Diseases
• Other Study ID Numbers: 10-1361