Patient education interventions to improve physical activity in patients with intermittent claudication: a protocol for a systematic mixed-studies review

Ukachukwu Okoroafor Abaraogu, Philippa Margaret Dall, Christopher Andrew Seenan, Ukachukwu Okoroafor Abaraogu, Philippa Margaret Dall, Christopher Andrew Seenan

Abstract

Introduction: Peripheral arterial disease (PAD) and intermittent claudication (IC) decrease an individual's capacity to engage in physical activity (PA) with potentially negative effects on PA behaviour. Strategies to improve PA among this population may provide a range of positive health benefits. We present a protocol to assess the components of patient education interventions that improve PA capacity and PA behaviour in patients with PAD and IC.

Methods and analysis: Published peer-reviewed studies will be searched in the following databases: CINAHL, the Cochrane Library, OVID, ProQuest, AMED, MEDLINE, PsycINFO, Web of Science Core Collection and PEDro, to identify literature investigating the effect of patient education on PA of patients with PAD and IC, or studies that investigated patients' perceptions or experience with these interventions. Two authors will independently perform screening for study eligibility, result synthesis and then appraise study quality. For interventions without follow-up, primary outcome measures will include change in PA capacity, or change in free-living PA behaviour; where there was a follow-up postintervention, the primary outcome will be rate of adherence to PA behaviour improvement. A three-phase sequential explanatory synthesis of mixed studies will be employed to answer the research questions. Homogenous quantitative data will be analysed using a random-effects model of meta-analysis with results presented as relative risk for dichotomous outcomes and as weighted or standardised means for continuous outcomes. Qualitative data will be analysed using thematic synthesis. This review protocol is reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines.

Trial registration number: CRD42015027314.

Keywords: Intermittent claudication; Patient education; Peripheral arterial diseases; Physical activity; Systematic review.

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References

    1. Fowkes FGR, Rudan D, Rudan I et al. . Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 2013;382:1329–40. 10.1016/S0140-6736(13)61249-0
    1. Hennion DR, Siano K. Peripheral vascular disease: diagnosis and treatment of peripheral arterial disease. Am Fam Physician 2013;88:306–10.
    1. Stewart KJ, Hiatt WR, Regensteiner JG et al. . Exercise training for claudication. N Engl J Med 2002;347:1941–51. 10.1056/NEJMra021135
    1. Bendermacher BL, Willigendael EM, Teijink JA et al. . Supervised exercise therapy versus non-supervised exercise therapy for intermittent claudication. Cochrane Database Syst Rev 2006;(2):CD005263.
    1. Johnstone CC. Living with peripheral vascular disease: a review of the literature. J Prof Nurs 2003;18:446–9.
    1. Treat-Jacobson D, Halverson SL, Ratchford A et al. . A patient-derived perspective of health-related quality of life with peripheral arterial disease. J Nurs Scholarsh 2002;34:55–60. 10.1111/j.1547-5069.2002.00055.x
    1. Gibson JM, Kenrick M. Pain and powerlessness: the experience of living with peripheral vascular disease. J AdvNurs 1998;27:737–45.
    1. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol 2012;2:1143–211. 10.1002/cphy.c110025
    1. Gornik HL, Joshua AB. Peripheral arterial disease. Circulation 2005;111:e169–72. 10.1161/01.CIR.0000160581.58633.8B
    1. Gardner AW, Poehlman ET. Exercise rehabilitation programs for the treatment of claudication pain. A meta-analysis. JAMA 1995;274: 975–80. 10.1001/jama.1995.03530120067043
    1. Regensteiner JG, Steiner JF, Hiatt WR. Exercise training improves functional status in patients with peripheral arterial disease. J Vasc Surg 1996;23:104–15. 10.1016/S0741-5214(05)80040-0
    1. Regensteiner JG, Ware JE, McCarthy WJ et al. . Effect of cilostazol on treadmill walking, community-based walking ability, and health-related quality of life in patients with intermittent claudication due to peripheral arterial disease: meta-analysis of six randomized controlled trials. J Am Geriatr Soc 2002;50:1939–46. 10.1046/j.1532-5415.2002.50604.x
    1. Aranow WS. Drug treatment of peripheral arterial disease in the elderly. Drugs Aging 2006;23:1–12. 10.2165/00002512-200623010-00001
    1. Kim CK, Schmalfuss CM, Schofield RS et al. . Pharmacological treatment of patients with peripheral arterial disease. Drugs 2003;63:637–47. 10.2165/00003495-200363070-00002
    1. Gardner AW, Parker DE, Montgomery PS et al. . Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: a randomized controlled trial. Circulation 2011;123:491–8. 10.1161/CIRCULATIONAHA.110.963066
    1. Cheetham DR, Burgess L, Ellis M et al. . Does supervised exercise offer adjuvant benefit over exercise advice alone for the treatment of intermittent claudication? A randomised trial. Eur J VascEndovasc Surg 2004;27:17–23. 10.1016/j.ejvs.2003.09.012
    1. Carman TL, Fernandez BA. A primary care approach to the patient with claudication. Am Fam Physician 2000;61:1027–32.
    1. Norgren L, Hiatt WR, Dormandy JA et al. . Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007;45(Suppl S):S5–67. 10.1016/j.jvs.2006.12.037
    1. Fowkes F, Armitage M, Belch J et al. . Diagnosis and management of Peripheral Arterial Disease. A National Clinical Guideline. Scottish Intercollegiate Guidelines Network. 2006;89 (October). (accessed 24 Oct 2015).
    1. Leng GC, Fowler B, Ernst E. Exercise for intermittent claudication. Cochrane Database Syst Rev 2000;(2):CD000990.
    1. Artinian NT, Fletcher GF, Mozaffarian D et al. . Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation 2010;122:406–41. 10.1161/CIR.0b013e3181e8edf1
    1. Kim JI, Lee S, Kim JH et al. . Effects of a web-based stroke education program on recurrence prevention behaviors among stroke patients: a pilot study. Health Educ Res 2013;28:488–501. 10.1093/her/cyt044
    1. de Blok BMJ, de Greef MHG, ten Hacken NH et al. . The effects of a lifestyle physical activity counseling program with feedback of a pedometer during pulmonary rehabilitation in patients with COPD: a pilot study. Patient Educ Couns 2006;61:48–55. 10.1016/j.pec.2005.02.005
    1. Galea MN, Weinman JA, White C et al. . Do behaviour-change techniques contribute to the effectiveness of exercise therapy in patients with intermittent claudication? A systematic review. Eur J Vasc Endovasc Surg 2013:46:132–41. 10.1016/j.ejvs.2013.03.030
    1. Al-Jundi W, Madbak K, Beard JD et al. . Systematic review of home-based exercise programmes for individuals with intermittent claudication. Eur J Vasc Endovasc Surg 2013;46:690–706.
    1. Moher D, Shamseer L, Clarke M et al. . Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1 10.1186/2046-4053-4-1
    1. Shamseer L, Moher D, Clarke M et al. . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015;349:g7647 10.1136/bmj.g7647
    1. Higgins J, Green S. Cochrane handbook for systematic reviews of interventions Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration, 2011. , 2014.
    1. Akers J, Aguiar-Ibáñez R, Baba-Akbari Sari A. CRD's guidance for undertaking reviews in health care. York, UK: Centre for Reviews and Dissemination (CRD), 2009.
    1. Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Ann Rev Public Health 2014;35:29–45. 10.1146/annurev-publhealth-032013-182440
    1. Pace R, Pluye P, Bartlett G et al. . Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review. Int J Nurs Stud 2012;49:47–53. 10.1016/j.ijnurstu.2011.07.002
    1. Cochrane Consumers and Communication Review Group. Communication review group: data extraction template for Cochrane reviews. Cochrane Collaboration, 2007.
    1. Noyes J & Lewin S. Chapter 5: Extracting qualitative evidence. In: Noyes J, Booth A, Hannes K et al., eds. Supplementary guidance for inclusion of qualitative research in Cochrane Systematic Reviews of interventions. Version 1 (updated August 2011). Cochrane Collaboration Qualitative Methods Group, 2011.
    1. Pluye P, Grad RM, Dunikowski LG et al. . Impact of clinical information-retrieval technology on physicians: a literature review of quantitative, qualitative and mixed methods studies. Int J Med Inform 2005;74:745–68. 10.1016/j.ijmedinf.2005.05.004
    1. Egger M, Davey Smith G, Schneider M et al. . Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629–34. 10.1136/bmj.315.7109.629
    1. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 2008;8:45 10.1186/1471-2288-8-45
    1. Guyatt GH, Oxman AD, Vist GE et al. . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924–6. 10.1136/
    1. Moher D, Liberati A, Tetzlaff J et al. . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097 10.1371/journal.pmed.1000097

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