THE IMPACT OF ATRIAL FIBRILLATION ON OUTCOMES OF PERIPHERAL ARTERIAL DISEASE: ANALYSIS OF ROUTINELY COLLECTED PRIMARY CARE DATA

2021 ◽  
Author(s):  
Antonios Vitalis ◽  
Krishnarajah Nirantharakumar ◽  
Rasiah Thayakaran ◽  
Rajiv K. Vohra ◽  
MarK. Kay ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Primary Care Data ◽  
Peripheral Arterial ◽  
The Impact ◽  
Disease Analysis

scholarly journals Peripheral arterial disease diagnosis and management in primary care: a qualitative study

BJGP Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. bjgpopen19X101659 ◽  
Author(s):  
Jan Lecouturier ◽  
Jason Scott ◽  
Nikki Rousseau ◽  
Gerard Stansby ◽  
Andrew Sims ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Disease Diagnosis ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Peripheral Arterial ◽  
The Impact

BackgroundPatients diagnosed with peripheral arterial disease (PAD) are at an increased risk of coronary heart disease, stroke, heart attack, and PAD progression. If diagnosed early, cardiovascular risk factors can be treated and the risk of other cardiovascular diseases can be reduced. There are clear guidelines on PAD diagnosis and management, but little is known about the issues faced in primary care with regards adherence to these, and about the impact of these issues on patients.AimTo identify the issues for primary care health professionals (HPs) and patients in PAD diagnosis and management, and to explore the impact of these on HPs and PAD patients.Design & settingQualitative study conducted in a primary care setting in the North East of England. Data was collected between December 2014 and July 2017.MethodSemi-structured interviews and focus groups were conducted with PAD register patients (n = 17), practice nurses ([PNs], n = 17), district nurses (DNs], n = 20), tissue viability nurses (n = 21), and GPs (n = 21).ResultsHPs’ attitudes to PAD, difficulty accessing tests, and patient delays impacted upon diagnosis. Some HPs had a reactive approach to PAD identification. Patients lacked understanding about PAD and some reported a delay consulting their GP after the onset of PAD symptoms. After diagnosis, few were attending for regular GP follow-up.ConclusionPatient education about PAD symptoms and risks, and questioning about exercise tolerance, could address the problem of under-reporting. Annual reviews could provide an opportunity to probe for PAD symptoms and highlight those requiring further investigation. Improved information when PAD is diagnosed and, considering the propensity for patients to tolerate worsening symptoms, the introduction of annual follow-up (at minimum) is warranted.

scholarly journals Platelet aggregation inhibitor prescription for newly diagnosed peripheral arterial disease in the Netherlands: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041715
Author(s):  
Aarent RT Brand ◽  
Eline Houben ◽  
Irene D Bezemer ◽  
Frank L J Visseren ◽  
Michiel L Bots ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
The Netherlands ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Free Text ◽  
Newly Diagnosed ◽  
Patient Journey ◽  
P2y12 Inhibitors ◽  
Peripheral Arterial

ObjectivesPharmacological treatment of peripheral arterial disease (PAD) comprises of antiplatelet therapy (APT), blood pressure control and cholesterol optimisation. Guidelines provide class-I recommendations on the prescription, but there are little data on the actual prescription practices. Our study provides insight into the prescription of medication among patients with PAD in the Netherlands and reports a ‘real-world’ patient journey through primary and secondary care.DesignWe conducted a cohort study among patients newly diagnosed with PAD between 2010 and 2014.SettingData were obtained from the PHARMO Database Network, a population-based network of electronic pharmacy, primary and secondary healthcare setting records in the Netherlands. The source population for this study comprised almost 1 million individuals.Participants‘Newly diagnosed’ was defined as a recorded International Classification of Primary Care code for PAD, a PAD-specific WCIA examination code or a diagnosis recorded as free text episode in the general practitioner records with no previous PAD diagnosis record and no prescription of P2Y12 inhibitors or aspirin the preceding year. The patient journey was defined by at least 1 year of database history and follow-up relative to the index date.ResultsBetween 2010 and 2014, we identified 3677 newly diagnosed patients with PAD. Most patients (91%) were diagnosed in primary care. Almost half of all patients (49%) had no APT dispensing record. Within this group, 33% received other anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant). Mono-APT was dispensed as aspirin (40% of patients) or P2Y12 inhibitors (2.5% of patients). Dual APT combining aspirin with a P2Y12 inhibitor was dispensed to 8.5% of the study population.ConclusionHalf of all patients with newly diagnosed PAD are not treated conforming to (international) guideline recommendations on thromboembolism prevention through APT. At least 33% of all patients with newly diagnosed PAD do not receive any antithrombotic therapy. Evaluation and improvement of APT prescription and thereby improved prevention of (secondary) cardiovascular events is warranted.

scholarly journals Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study

2020 ◽  
Vol 41 (1) ◽  
pp. 61-67
Author(s):  
Tolga Vural ◽  
Makbule Neslişah Tan ◽  
Mehtap Kartal ◽  
Azize Dilek Güldal
Keyword(s):  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Population Based ◽  
Population Based Study ◽  
Peripheral Arterial

scholarly journals Prevalence and predictors of peripheral arterial disease determined by ankle brachial index in diabetes population treated within primary care services in a non-urban area of lower northern Thailand

2020 ◽  
Vol 17 (6) ◽  
pp. 147916412096699
Author(s):  
Preaw Suwannasrisuk ◽  
Sarinya Sattanon ◽  
Watcharaporn Taburee ◽  
Pantitra Singkheaw ◽  
Non Sowanna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
University Hospital ◽  
Peripheral Arterial ◽  
Diabetes Patients

In diabetes patients, urban lifestyle has been concerned as one of the risk factors for peripheral arterial disease (PAD). The aims of this study were to find out the prevalence and associated risk factors of PAD in type 2 diabetes patients who live in a non-urban community area. A total of 885 participants with type 2 diabetes mellitus were enrolled from six primary care units in the health network centered at Naresuan University Hospital, Phitsanulok, between May and June 2018. Ankle-brachial index (ABI) was performed in all subjects using a vascular screening device. PAD was defined by an ABI value of 0.9 or lesser at least on one leg. The predictors of PAD were analyzed using multiple logistic regression. The prevalence of PAD was 7.2% among 884 evaluable patients. Diabetic neuropathy and a history of macrovascular complications were significant predictors of PAD.

Peripheral Arterial Disease in Patients with Atrial Fibrillation: The AFFIRM Study

2020 ◽  
Author(s):  
Antonios Vitalis ◽  
Alena Shantsila ◽  
Marco Proietti ◽  
Rajiv K. Vohra ◽  
Mark Kay ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Peripheral Arterial
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