Mobile educational follow-up application for patients with peripheral arterial disease

ABSTRACT Objective: to describe the development of a prototype mobile educational application for nursing follow-up aimed at patients diagnosed with peripheral arterial disease. Method: a prototype-based technological production study. The construction followed the contextualized instructional design model using two steps: analysis and design and development. Results: the pedagogical content of the application was based on a survey of needs of patients with Peripheral Arterial Disease and treatments recommended in the literature. The prototype developed contained concepts, risk factors, signs and symptoms, treatment, importance of medications and their side effects, frequent doubts, necessary health care, and follow-up of patients by monitoring the evolution of the cicatricial process of lesions and possible complications, clarification of doubts and stimulus for continuation of treatment. Conclusion: the use of health applications is a technological tool with the potential to improve the follow-up of patients regarding the progress of the disease and self-care, monitoring of risk factors, co-participation of the patient in the treatment, family participation, as well as planning of individualized care, and cost reduction for the health system.

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Abstract 278: Lipid Control in Patients With New Symptoms of Peripheral Arterial Disease Evaluated at Vascular Specialty Clinics

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.6.suppl_1.a278 ◽

2013 ◽

Vol 6 (suppl_1) ◽

Author(s):

Kim Smolderen ◽

Jan-Willem Elshof ◽

Moniek van Zitteren ◽

John A Spertus ◽

Johan Denollet ◽

...

Keyword(s):

Risk Factors ◽

Peripheral Arterial Disease ◽

Secondary Prevention ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Initial Evaluation ◽

Specialty Clinic ◽

Lipid Control ◽

Peripheral Arterial

Background: Obtaining adequate lipid control (LDL-Cholesterol [LDL] <100 mg/dL) in patients with peripheral arterial disease (PAD) is a critical, guideline-directed secondary prevention target. Current compliance with this recommendation is unknown. Methods: A total of 616 patients had their LDL levels measured at 2 vascular specialty clinics in the Netherlands (March 2006-November 2011) during the evaluation of new PAD symptoms. A year following this evaluation, 417 (68%) patients had their LDL levels re-assessed. Information about patients’ demographic and clinical factors was systematically abstracted from medical records. Categories of patients were created based on the attainment of the recommended LDL target (<100 mg/dL [on target] vs. ≥100 mg/dL [off target]). Predictors of being off target at initial evaluation and at 1-year follow-up were identified through multivariable logistic regression analyses. Results: Of the total group, 57% (351/616) were off target at initial evaluation and 81% (496/616) were on lipid-lowering drugs after the initial evaluation at the PAD specialty clinic. One year later, only 25% (103/417) got on target, while 35% (147/417) patients remained off target, and an additional 10% (43/417) saw an increase in LDL to become off target. A total of 30% (124/417) remained on target. Patients with hypertension, diabetes, a history of myocardial infarction, and a lower ankle-brachial index were less likely to be off target at initial evaluation. Predictors of being off target at 1-year follow-up were male sex, and having a higher ankle-brachial index ( Table ). Conclusion: About half of patients with PAD seen at vascular specialty clinics had above-target LDL levels both upon entry and 1 year later. Patients with existing cardiovascular risk factors were much better controlled, as compared with patients without such risk factors. Males and those with higher ankle-brachial indices were less likely to be on target 1 year following management at the specialty clinic. Reasons for poorly regulated lipids need to be further explored, and appropriate quality-of-care improvement strategies will likely be needed to optimize secondary prevention.

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Depressive symptoms in peripheral arterial disease: A follow-up study on prevalence, stability, and risk factors

Journal of Affective Disorders ◽

10.1016/j.jad.2007.12.238 ◽

2008 ◽

Vol 110 (1-2) ◽

pp. 27-35 ◽

Cited By ~ 49

Author(s):

Kim G.E. Smolderen ◽

Annelies E. Aquarius ◽

Jolanda de Vries ◽

Otto R.F. Smith ◽

Jaap F. Hamming ◽

...

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Follow Up Study ◽

Peripheral Arterial

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Abstract P251: The Impact of Clinical Risk Factors on Risk of Peripheral Arterial Disease in Men

Circulation ◽

10.1161/circ.125.suppl_10.ap251 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Michel M Joosten ◽

Jennifer K Pai ◽

Eric B Rimm ◽

Donna Spiegelman ◽

Murray A Mittleman ◽

...

Keyword(s):

Risk Factors ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Clinical Risk Factors ◽

Individual Risk ◽

Clinical Risk ◽

Hazard Ratios ◽

History Of ◽

Peripheral Arterial

Background: Previous studies have examined individual risk factors in relation to peripheral arterial disease (PAD) but the combined effects of these factors are largely unknown. We investigated the degree to which clinical risk factors may explain the risk of PAD among men. Methods: We prospectively followed 45,596 men from the Health Professional Follow-up Study without a history of cardiovascular disease at baseline during a 22-year period (1986–2008). We defined four clinical risk factors - smoking, history of type 2 diabetes, hypertension, and hypercholesterolemia - that were updated biennially during follow-up. Cox proportional hazard models were used to compare PAD risk across individual and joint risk factors. Results: During 874,769 person-years of follow-up, 497 confirmed PAD cases occurred. All four clinical risk factors were significantly and independently associated with a higher risk of PAD after multivariate adjustment (Figure). Risk of PAD more than doubled (hazard ratio: 2.14; 95% confidence interval [95% CI]: 1.95–2.35) for each additional risk factor compared with the group free of risk factors. Men without any of the four risk factors had a relative risk of PAD of 0.19 compared with all other men (95% CI: 0.11–0.31). In 96.8% (95% CI: 95.2–98.3%) of the PAD cases, at least one of the four risk factors was present. Overall, 8 out of 10 cases of PAD appeared to be attributable to these four conventional risk factors. Conclusion: The great majority of PAD can be explained by four conventional risk factors. Figure legend: Hazard ratios for incident peripheral arterial disease (PAD) according to individual and joint risk factors. Hazard ratios are adjusted for age, height, aspirin use, family history of myocardial infarction before age 60 y, geographical region, body mass index, physical activity, alcohol consumption (and each of the other three binary clinical risk factors in the individual risk factor analyses).

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