Multidisciplinary treatment for peripheral arterial occlusive disease and the role of eHealth and mHealth

Hugo Jp Fokkenrood, Gert-Jan Lauret, Marc Rm Scheltinga, Cor Spreeuwenberg, Rob A de Bie, Joep Aw Teijink, Hugo Jp Fokkenrood, Gert-Jan Lauret, Marc Rm Scheltinga, Cor Spreeuwenberg, Rob A de Bie, Joep Aw Teijink

Abstract

Increasingly unaffordable health care costs are forcing care providers to develop economically viable and efficient health care plans. Currently, only a minority of all newly diagnosed peripheral arterial occlusive disease (PAOD) patients receive efficient and structured conservative treatment for their disease. The aim of this article is to introduce an innovative effective treatment model termed ClaudicatioNet. This concept was launched in The Netherlands as a means to combat treatment shortcomings and stimulate cohesion and collaboration between stakeholders. The overall goal of ClaudicatioNet is to stimulate quality and transparency of PAOD treatment by optimizing multidisciplinary health care chains on a national level. Improved quality is based on stimulating both a theoretical and practical knowledge base, while eHealth and mHealth technologies are used to create clear insights of provided care to enhance quality control management, in addition these technologies can be used to increase patient empowerment, thereby increasing efficacy of PAOD treatment. This online community consists of a web portal with public and personal information supplemented with a mobile application. By connecting to these tools, a social community is created where patients can meet and keep in touch with fellow patients, while useful information for supervising health care professionals is provided. The ClaudicatioNet concept will likely create more efficient and cost-effective PAOD treatment by improving the quality of supervised training programs, extending possibilities and stimulating patient empowerment by using eHealth and mHealth solutions. A free market principle is introduced by introducing transparency to provided care by using objective and subjective outcome parameters. Cost-effectiveness can be achieved using supervised training programs, which may substitute for or postpone expensive invasive vascular interventions.

Keywords: cost-effectiveness; eHealth; intermittent claudication; multidisciplinary treatment.

Figures

Figure 1
Figure 1
Schematic overview of role models within the ClaudicatioNet (CNet) Concept. Abbreviations: PT, physical therapist; CHP, coordinating health care professional; AUX TREAT, auxiliary treatment professional; SET, supervised exercise treatment; CVRM, cardiovascular risk management; T, treatment; SCP, social community platform.

References

    1. Rapport De zorg: hoeveel extra is het ons waard? (Dutch Government Report: healthcare, how much is it worth extra?) Dutch Ministry of Health Welfare and Sports. 2012 Jun 12; (Dutch)
    1. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) J Vasc Surg. 2007;45(Suppl S):S5–S67.
    1. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation. 2004;110(6):738–743.
    1. Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006;113(11):e463–e654.
    1. Lauret GJ, van Dalen DC, Willigendael EM, et al. Supervised exercise therapy for intermittent claudication: current status and future perspectives. Vascular. 2012;20(1):12–19.
    1. Criqui MH. Systemic atherosclerosis risk and the mandate for intervention in atherosclerotic peripheral arterial disease. Am J Cardiol. 2001;88(7B):43J–47J.
    1. Criqui MH, Langer RD, Fronek A, et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med. 1992;326(6):381–386.
    1. Dormandy J, Heeck L, Vig S. Predictors of early disease in the lower limbs. Semin Vasc Surg. 1999;12(2):109–117.
    1. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360(9326):7–22.
    1. Erb W. About intermittent walking and nerve disturbances due to vascular disease [Uber das “intermitterende Hinken” und adere nervose Storungen in Folge von Gefasserkrankungen] Deutsch Z Nervenheilk. 1898;13:1–76.
    1. Watson L, Ellis B, Leng GC. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2008;4:CD000990.
    1. Bendermacher BL, Willigendael EM, Teijink JA, Prins MH. Supervised exercise therapy versus non-supervised exercise therapy for intermittent claudication. Cochrane Database Syst Rev. 2006;19(2):CD005263.
    1. Nicolai SP, Teijink JA, Prins MH Exercise Therapy in Peripheral Arterial Disease Study Group. Multicenter randomized clinical trial of supervised exercise therapy with or without feedback versus walking advice for intermittent claudication. J Vasc Surg. 2010;52(2):348–355.
    1. Bartelink M, Stoffers H, Boutens E, Hooij J, Kaiser V, Boomsma L. NHG-standaard Perifeer arterieel vaatlijden [Guideline peripheral arterial disease from the Dutch General Practioners Society] Huisarts en Wetenschap. 2003;46:848–858.
    1. Vahl AC, Reekers JC. Richtlijn diagnostiek en behandeling van arterieel vaatlijden van de onderste extremiteit. (The guideline, Diagnosis and treatment of peripheral artery disease of the lower extremities.) Ned Tijdschr Geneeskd. 2005 Jul 23;149(30) (Dutch)
    1. Lauret GJ, van Dalen HC, Hendriks HJ, et al. When is supervised exercise therapy considered useful in peripheral arterial occlusive disease? A nationwide survey among vascular surgeons. Eur J Vasc Endovasc Surg. 2012;43(3):308–312.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する