Improving outcomes in patients with peripheral arterial disease

Area of Science:

• Vascular Medicine
• Cardiology
• Quality Improvement Initiatives

Background:

• Peripheral arterial disease (PAD) management benefits from addressing modifiable risk factors.
• Established literature supports risk-factor reduction for PAD patients.
• Quality of life (QoL) and ambulation are key outcomes in PAD care.

Purpose of the Study:

• To reduce modifiable risk factors (diabetes mellitus, hypertension, hyperlipidemia, tobacco use) in PAD patients.
• To evaluate improvements in quality of life (QoL) and 6-minute-walk distances.
• To assess the impact of an individualized risk-factor management plan post-intervention.

Main Methods:

• A quality-improvement project involving 24 PAD patients over 6 weeks.
• Baseline assessments included 6-minute-walk test, Vas QoL-6 questionnaire, and Rutherford classification.
• Post-endovascular intervention, an individualized plan addressed risk factors, medication adjustments, and a walking program.

Main Results:

• Significant improvement in low-density lipoprotein cholesterol (P=.007).
• Significant improvements in Vas QoL-6 scores (P<.001) and 6-minute-walk distance (P=.03).
• Statistically significant decrease in Rutherford class scores (P<.001); 57.1% of tobacco users reduced use.

Conclusions:

• PAD risk factors, including blood pressure, cholesterol, A1c, and smoking, can be improved.
• Risk factor control is crucial for improving PAD morbidity, mortality, and quality of life.
• Close follow-up post-intervention enhances ambulation; supervised exercise programs may improve adherence.