Knowledge of peripheral artery disease: What do the public, healthcare practitioners, and trainees know?

Abstract

This systematic review evaluated the knowledge and awareness of peripheral artery disease (PAD) within the general public (including patients with peripheral vascular disease), nonspecialist healthcare professionals (nsHCP), and trainees (medical students and trainee doctors). Relevant articles were identified from electronic databases using key search terms: ‘peripheral artery disease’; ‘limb ischaemia’; ‘intermittent claudication’; ‘knowledge’; ‘understanding’; ‘public’; ‘medical professional’. The heterogeneous results were described narratively. A lack of knowledge and understanding of PAD (disease awareness) were identified in all groups. Among nsHCPs, factors which affect knowledge include the level of training, early clinical exposure and the presence of family members with cardiovascular/vascular disease. Within the general public, knowledge and awareness was improved if a family member/friend had a diagnosis, or following a patient-centred consultation with any HCP. Public campaigns are proven effective in improving disease knowledge/awareness in conditions such as stroke alongside sustained patient education. These may provide future avenues to improve PAD knowledge and awareness, in order to effectively manage risk factors and minimise delayed or missed diagnosis of PAD. (PROSPERO registration number: CRD42018117304)

Training experience with community health agents: Focus on prevention and identification of stroke

“…Some authors emphasize that knowledge and professional integrity in relation to the disease could be improved through various actions such as training, public campaigns, interaction with family members having suffered a stroke and professional experience, corroborating with our findings. [11] The difficulties reported for becoming multipliers of learning about Stroke were informed as overload in the work process, thus unhealthy working conditions, deserve a sensitive listening by health managers. Increased workload and wellbeing have a cause-effect relation related to excessive overtime, extensive tenures in the work environment are stressors associated to the health professionals.…”

Positive and negative well-being of older adults with symptomatic peripheral artery disease: A population-based investigation

“…Uncertainty about whether lifestyle changes, such as walking, actually help or make the condition worse, may be common. 41 Persons with PAD have also expressed lack of understanding and empathy from others, including from health professionals, resulting in feelings of being dismissed and left on their own. 39 Negative experiences such as these may potentially induce feelings of anxiety and fear in those affected by PAD 37 which subsequently could undermine their sense of independence or satisfaction with life.…”

“…For example, the onset of pain or discomfort when ambulating, particularly when attempting to walk faster or on slopes, may be the most common barrier to physical activity in affected individuals. 41 In response, they may deliberately slow their walking speed, or limit their walking activity, in order to avoid exertional leg symptoms. 40 As a marker of impaired physical functioning, reduced walking distance has been found to be a significant predictor of general health, physical and social function in those with PAD.…”

“…42 Furthermore, lower-limb vascular morbidity is associated with diverse psychosocial experiences which may adversely influence individuals' perceived well-being. For example, affected persons often lack appropriate understanding of the underlying pathophysiology and risk factors for PAD; 41 PAD symptoms may also be confused with other diagnoses, including chronic venous or musculoskeletal conditions. Some individuals assume that their pain will dissipate with time, whereas others consider their leg symptoms to be part of normal ageing.…”

One-year follow-up of patients screened for lower extremity arterial disease

“…This is especially important as the number of amputation cases in Hungary are manifold compared to that of international peers published in the literature [13,14]. The main reason behind this is because patients with LEAD-positivity generally remains undiagnosed at the level of primary care practitioners [15][16][17][18][19]. Guidelines could be particularly important in establishing the diagnosis, however according to a recent study there are several discrepancies between the different guidelines, especially concerning the diagnosis and treatment of asymptomatic patients [20].…”