Dallas [US]: According to a new American Heart Association scientific statement published today in the Association's premier, peer-reviewed journal Circulation, the criteria for success for the roughly 8.5 million Americans with peripheral artery disease (PAD, pronounced P-A-D), which is characterised by narrowed or clogged arteries in the legs, should be driven by their symptoms.
A scientific statement from the American Heart Association is a professional evaluation of recent findings that could influence future practice recommendations. Managing Peripheral Artery Disease (PAD) based on a person's experience of symptoms can result in more patient-centred care and outcomes, with a focus on high-value care, compared to relying on clinical measures like the rate of blood flow to the legs or artery diameter. This is highlighted in the statement, "Advancing peripheral artery disease quality of care and outcomes through patient-reported health status assessment."
"The person living with peripheral artery disease is the authority on its impact on their daily life. Our treatment must be grounded in their lived experiences and go beyond the clinical measures of how well blood flows through the arteries," said Vice Chair and lead author of the statement writing group Kim G. Smolderen, PhD, a clinical psychologist and an associate professor of medicine and psychiatry and co-director of the Vascular Medicine Outcomes Research (VAMOS) lab at Yale University in New Haven, Connecticut.
"We have spent years developing and validating standardized instruments to capture people's experiences in a reliable and sensitive way. We are now at a point where we can start integrating this information into real-world care, through pilot programs that can develop quality benchmarks for different phenotypes of patients with PAD and the types of treatments they undergo, as seen from their perspective."
Painful Legs and Other Patient Experiences: Although those who have Peripheral Artery Disease (PAD) tend to be older than 40, it can also affect younger people. People with PAD have blockages in the arteries that carry blood to their legs and feet, which frequently results in pain, cramping, or weakness when they walk, necessitating a brief break to ease the discomfort. Although some people have no symptoms, many patients may only have no pain because they restrict their activities.
Their functionality and health status are also impaired, according to studies. People who have critical limb ischemia, or highly restricted blood supply to the legs, may endure discomfort even while at rest, have wounds that do not heal or develop gangrene that could result in an amputation. Another risk factor for heart attack or stroke is PAD.
The everyday functioning and quality of life of patients are significantly impacted by all of these manifestations, with the impact growing as the disease's severity rises. Other medical diseases like Type 2 diabetes, coronary artery disease, kidney dysfunction, or mental health issues like depression or stress-related illnesses that are frequent in persons with PAD can have an impact on outcomes, according to Smolderen.
Patient-led Treatment: Coordination of care for risk factors and patient concerns is prioritised when the healthcare team is more aware of the impact of disease on quality of life. The statement urges gathering feedback from patients' therapy experiences to enhance and personalise care for those with obstructed leg arteries.