Peripheral arterial disease diagnosis and management in primary care: a qualitative study.
Diagnosis
General practice
Peripheral arterial disease
Primary care
Qualitative research
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
01
07
2019
accepted:
09
07
2019
pubmed:
4
10
2019
medline:
4
10
2019
entrez:
4
10
2019
Statut:
epublish
Résumé
Patients 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. To 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. Qualitative study conducted in a primary care setting in the North East of England. Data was collected between December 2014 and July 2017. Semi-structured interviews and focus groups were conducted with PAD register patients ( HPs' 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. Patient 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.
Sections du résumé
BACKGROUND
BACKGROUND
Patients 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.
AIM
OBJECTIVE
To 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 & SETTING
METHODS
Qualitative study conducted in a primary care setting in the North East of England. Data was collected between December 2014 and July 2017.
METHOD
METHODS
Semi-structured interviews and focus groups were conducted with PAD register patients (
RESULTS
RESULTS
HPs' 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.
CONCLUSION
CONCLUSIONS
Patient 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.
Identifiants
pubmed: 31581118
pii: bjgpopen19X101659
doi: 10.3399/bjgpopen19X101659
pmc: PMC6970582
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Department of Health
ID : II-C1-0412-20003
Pays : United Kingdom
Informations de copyright
Copyright © 2019, The Authors.
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