A Comparison of Health Status and Quality of Life in Patients with Intermittent Claudication

Roijers, Joost P.; Houten, Marijn M.L. van den; Hopmans, Cornelis J.; Vriens, Patrick W.; Willigendael, Edith M.; Lodder, Paul; Vries, Jolanda De; Teijink, Joep A.W.; Laan, Lijckle van der

doi:10.1016/j.avsg.2021.06.040

Cited by 2 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings suggest that using POFs primarily impacts process measures and subjective patient outcomes, such as SDM and HRQoL, rather than objective patient outcomes, such as FWD or MWD. It seems plausible that patients’ perceived quality of life involves more than measured walking distances 54. Therefore, the observed differences in SDM and HRQoL could potentially be attributed to broader conversations and motivations initiated by using POFs, extending beyond the scope of walking, such as lifestyle modifications.…”

Section: Discussionmentioning

confidence: 99%

“…It seems plausible that patients’ perceived quality of life involves more than measured walking distances. 54 Therefore, the observed differences in SDM and HRQoL could potentially be attributed to broader conversations and motivations initiated by using POFs, extending beyond the scope of walking, such as lifestyle modifications. In a vignette study conducted by Sinnige et al , therapists suggested that the POFs could provide a springboard for setting secondary therapy goals together, such as gaining strength or increasing daily activity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study

Marcellis,

Sinnige,

Rutgers

et al. 2024

BMJ Open Qual

Self Cite

View full text Add to dashboard Cite

BackgroundTo support the optimisation of supervised exercise therapy (SET) in patients with intermittent claudication, we developed personalised outcomes forecasts (POFs), which visualise estimated walking distance and quality of life for individual patients. The POFs may enable healthcare professionals, such as physical and exercise therapists, to improve shared decision-making and patient outcomes.ObjectivesTo assess differences in patient outcomes (functional walking distance, maximal walking distance and health-related quality of life) and the level of shared decision-making before and after the implementation of POFs in the conservative treatment of patients with intermittent claudication.MethodsAn interrupted time series design was used to compare preimplementation and postimplementation differences on patient outcomes. Using routinely collected data, differences from baseline to 6 months were compared between patients before and patients after the implementation. To compare levels of shared decision-making, we conducted observations of initial consults within a sample of physical or exercise therapists both before and after the implementation. Audiorecords of observations were scored on shared decision-making using the OPTION-5 instrument.ResultsDifferences in improvements between patients with whom POFs were discussed (n=317) and patients before the implementation of POFs (n=721) did not reach statistical significance for both functional walking distance (experimental vs. control=+23%, p=0.11) and maximal walking distance (experimental vs. control=+21%, p=0.08). For health-related quality of life, the POFs-informed patients showed a statistically significant greater improvement of 4% (p=0.04). Increased levels of shared decision-making were observed in postimplementation consults (n=20) when compared with preimplementation consults (n=36), as the median OPTION-5 total score showed a statistically significant increase from 45 to 55 points (p=0.01).ConclusionsIntegrating POFs into daily practice of SET for patients with intermittent claudication could assist in improving health-related quality of life and enhancing patient involvement. Using POFs did not result in statistically significant different improvements between groups on walking distances.Trial registration numberNL8838.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study

Marcellis,

Sinnige,

Rutgers

et al. 2024

BMJ Open Qual

Self Cite

View full text Add to dashboard Cite

show abstract

Quantifying patients’ preferences on tradeoffs between mortality risk and reduced need for target vessel revascularization for claudication

Reed,

Sutphin,

Wallace

et al. 2024

Vasc Med

View full text Add to dashboard Cite

Background: In 2019, the US Food and Drug Administration issued a warning that symptomatic relief from claudication using paclitaxel-coated devices might be associated with an increase in mortality over 5 years. We designed a discrete-choice experiment (DCE) to quantify tradeoffs that patients would accept between a decreased risk of clinically driven target-vessel revascularization (CDTVR) and increased mortality risk. Methods: Patients with claudication symptoms were recruited from seven medical centers to complete a web-based survey including eight DCE questions that presented pairs of hypothetical device profiles defined by varying risks of CDTVR and overall mortality at 2 and 5 years. Random-parameters logit models were used to estimate relative preference weights, from which the maximum-acceptable increase in 5-year mortality risk was derived. Results: A total of 272 patients completed the survey. On average, patients would accept a device offering reductions in CDTVR risks from 30% to 10% at 2 years and from 40% to 30% at 5 years if the 5-year mortality risk was less than 12.6% (95% CI: 11.8–13.4%), representing a cut-point of 4.6 percentage points above a baseline risk of 8%. However, approximately 40% chose the device alternative with the lower 5-year mortality risk in seven (20.6%) or eight (18.0%) of the eight DCE questions regardless of the benefit offered. Conclusions: Most patients in the study would accept some incremental increase in 5-year mortality risk to reduce the 2-year and 5-year risks of CDTVR by 20 and 10 percentage points, respectively. However, significant patient-level variability in risk tolerance underscores the need for systematic approaches to support benefit-risk decision making.

show abstract

A Comparison of Health Status and Quality of Life in Patients with Intermittent Claudication

Cited by 2 publications

References 16 publications

Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study

Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study

Quantifying patients’ preferences on tradeoffs between mortality risk and reduced need for target vessel revascularization for claudication

Contact Info

Product

Resources

About