Patients' Perspectives of Factors That Support the Management of Peripheral Arterial Disease for Improved Outcomes
Condition: Peripheral Arterial Diseases
MeSH terms: Peripheral Arterial Disease; Peripheral Vascular Diseases
Study type: Observational

Summary: 
      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.
    

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.
    

Observational model: Cohort
Time perspective: Prospective
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.
      
Keywords: Peripheral Arterial Disease (PAD); Qualitative analysis; Patients' perspective