Medical Resource Consumption and Quality of Life in Peripheral Arterial Disease in Korea: PAD Outcomes (PADO) Research
- Author:
Seung Woon RHA
1
;
Seung Hyuk CHOI
;
Doo Il KIM
;
Dong Woon JEON
;
Jae Hwan LEE
;
Kyung Soon HONG
;
Tae Joon CHA
;
Jang Hyun CHO
;
Sang Kon LEE
;
Yong Hwan PARK
;
Woo Jung PARK
;
Hyun Joo KIM
;
Young Joo KIM
;
Juneyoung LEE
;
Donghoon CHOI
;
Author Information
- Publication Type:Multicenter Study
- Keywords: Peripheral arterial disease; Disease burden; Quality of life
- MeSH: Adult; Angiography; Ankle Brachial Index; Arteries; Aspirin; Comorbidity; Constriction, Pathologic; Diagnosis; Drug Therapy; Extremities; Humans; Hyperlipidemias; Hypertension; Ischemia; Korea; Linear Models; Male; Orthopedics; Peripheral Arterial Disease; Prospective Studies; Quality of Life; Smoking Cessation; Ultrasonography
- From:Korean Circulation Journal 2018;48(9):813-825
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: We aimed to investigate the history of medical resource consumption and quality of life (QoL) in peripheral arterial disease (PAD) patients in Korea. METHODS: This was a prospective, multi-center (23 tertiary-hospitals, division of cardiology), non-interventional study. Adult patients (age ≥20 years) suffering from PAD for the last 12-month were enrolled in the study if they met with any of following; 1) ankle-brachial index (ABI) ≤0.9, 2) lower-extremity artery stenosis on computed tomography angiography ≥50%, or 3) peak-systolic-velocity-ratio (PSVR) on ultrasound ≥2.0. Medical chart review was used to assess patient characteristics/treatment patterns while the history of medical resource consumption and QoL data were collected using a patient survey. QoL was measured using EuroQoL-5-dimensions-3-level (EQ-5D-3L) score system, and the factors associated with QoL were analyzed using multiple linear regression analysis. RESULTS: This study included 1,260 patients (age: 69.8 years, male: 77.0%). The most prevalent comorbidities were hypertension (74.8%), hyperlipidemia (51.0%) and diabetes-mellitus (50.2%). The 94.1% of the patients took pharmacotherapy including aspirin (76.2%), clopidogrel (53.3%), and cilostazol (33.6%). The 12.6% of the patients were receiving smoking cessation education/pharmacotherapy. A considerable number of patients (500 patients, 40.0%) had visit history to another hospital before diagnosis/treatment at the current hospital, with visits to orthopedic units (50.4%) being the most common. At the time, 29% (or higher) of the patients were already experiencing symptoms of critical limb ischemia. Baseline EQ-5D index and EQ VAS were 0.64±0.24 and 67.49±18.29. Factors significantly associated with QoL were pharmacotherapy (B=0.05053; p=0.044) compared to no pharmacotherapy, and Fontaine stage improvement/maintain stage I (B=0.04448; p < 0.001) compared to deterioration/maintain stage II–IV. CONCLUSIONS: Increase in disease awareness for earlier diagnosis and provision of adequate pharmacotherapy is essential to reduce disease burden and improve QoL of Korean PAD patients.