Medical Resource Consumption and Quality of Life in Peripheral Arterial Disease in Korea: PAD Outcomes (PADO) Research

A systematic review of patient-reported outcome measures patients with chronic limb-threatening ischemia

Chronic limb-threatening ischemia (CLTI) causes significant morbidity with profound negative effects on health-related quality of life. As the prevalence of peripheral artery disease and diabetes continue to rise in our aging population, the public health impact of CLTI has escalated. Patient-reported outcome measures (PROMs) have become common and important measures for clinical evaluation in both clinical care and research. PROMs are important for the measurement of clinical effectiveness and cost effectiveness and for shared decision-making on treatment options. However, the PROMs used to describe the experience of patients with CLTI are heterogeneous, incomplete, and lack specific applicability to the underlying disease processes and diverse populations. For example, certain PROMs exist for patients with extremity wounds, and other PROMs exist for patients with pain, and still others exist for patients with vascular disease. Despite this multiplicity of tools, no single PROM encompasses all of the components necessary to describe the experiences of patients with CLTI. This significant unmet need is evident from both published reports and contemporary large-scale clinical trials in the field. In this systematic review, we review the current use of PROMs for patients with CLTI in clinical practice and in research trials and highlight the gaps that need to be addressed to develop a unifying PROM instrument for CLTI.

Functional Status and Health-Related Quality of Life in Patients with Peripheral Artery Disease: A Cross-Sectional Study

Peripheral artery disease (PAD) is a progressive atherosclerotic disease that negatively affects individuals’ functional status and health-related quality of life (HRQOL). This study aimed to investigate the HRQOL and associated factors in patients with PAD in Korea. We conducted a cross-sectional study using self-administered questionnaires in a tertiary hospital in Seoul. We measured HRQOL using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) questionnaire and the functional status using a PAD-specific walking impairment questionnaire. We also measured health behavior, social support, walking impairment, general health perceptions, and clinical characteristics; lastly, we performed a descriptive analysis and multiple linear regression analysis. Participants of this study comprised 138 patients (mean age 69.04 ± 10.94 years; men 91.3%). The mean EQ-5D-5L utility score was 0.81 ± 0.17. The patients’ HRQOL was significantly associated with claudication pain (β = −0.188, p = 0.012), walking distance (β = 0.371, p < 0.001), and stair climbing (β = 0.315, p = 0.001). The regression model predicted 60.4% of patients’ HRQOL (F = 15.92, p < 0.001). Our study showed that less severe claudication pain and a low degree of difficulty in walking distance and stair climbing were significantly related to better HRQOL. To enhance patients’ HRQOL, health professionals should focus on managing symptoms and improving functional status.