Peripheral arterial disease: Scoping review of patient-centred outcomes.
Study Goal
The researchers aimed to evaluate the effectiveness of structured walking interventions and calf muscle activity in improving patient-centered outcomes for individuals with peripheral arterial disease (PAD).
Results Summary
The study found that structured walking interventions or those increasing calf muscle activity improved walking, quality of life, and pain reduction, particularly when administered before PAD became severe. Severe PAD cases showed more frequent improvements in amputation incidence and ulcer healing, often in response to invasive interventions.
Population
Patients with peripheral arterial disease (PAD), including those with varying severity levels.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
interventions administered before PAD became severe | increase | Walking, pain or QOL | patients | - | improved | #1 |
- | neutral | Amputation incidence, pain and ulcer healing | those with severe PAD | - | more frequently reported | #2 |
structured walking interventions or those increasing calf muscle activity | increase | walking, QOL, or pain reduction | patients | - | experienced more likely improved | #3 |
invasive interventions | decrease | amputation | those with more severe PAD | - | more likely to report amputation reduction | #4 |
multidisciplinary PAD management with supervised walking or calf muscle activity | increase | patient-centred outcomes | those with PAD | - | experienced more consistently improved | #5 |
multidisciplinary PAD management with supervised walking or calf muscle activity | decrease | amputation risk | those with more severe PAD | - | more likely amputation risk reduced | #6 |
Peripheral arterial disease (PAD) impairs patients' quality of life (QOL), walking and ulcer healing, increasing patient pain, costs, and risks of amputation or mortality. A literature appraisal described PAD treatment capacity to improve validated patient-centred outcomes in controlled clinical studies. The PUBMED database was searched from 1 January 1970 to 21 June 2018, for original and derivative controlled clinical trial references addressing MeSH terms for 'ischemia' AND 'leg ulcer'. Non-ischemic ulcer treatment references were excluded. Frequencies of improved (P < .05) outcomes were reported. Eighty-eight studies on 4153 patients were summarized. Walking, pain or QOL improved mainly for interventions administered before PAD became severe. Amputation incidence, pain and ulcer healing were more frequently reported in those with severe PAD. Independent of PAD severity, patients experienced more likely improved walking, QOL, or pain reduction in response to structured walking interventions or those increasing calf muscle activity. Those with more severe PAD were more likely to report amputation reduction, mainly in response to invasive interventions. Those with PAD experienced more consistently improved patient-centred outcomes if they received multidisciplinary PAD management with supervised walking or calf muscle activity, with more likely amputation risk reduced for those with more severe PAD.