Peripheral arterial disease (PAD) is a disease in which plaque builds up in the arteries. Over time, plaque can harden and narrow the arteries, limiting the flow of oxygen. PAD is most common in arteries of the leg and affects 7.3 million Americans. Over 5% of all adults have intermittent claudication, a form of PAD that limits the ability to walk.
There are three main treatment methods for claudication: non-intervention (anti-platelet medication, smoking cessation, physical therapy), endovascular interventions (angioplasty and/or stents), and surgical bypass. These treatments are used by clinicians in three specialties: vascular surgery, interventional cardiology, and interventional radiology. Because treatments for PAD and claudication are spread across three different medical specialties, doctors treating them rarely have the opportunity to work together or share information about treatment successes and failures. Consequently, it is not clear which treatment option is best, and there is no cohesive quality improvement or research efforts that encompass all clinical specialties.
In partnership with the Surgical Care and Outcomes Assessment Program (SCOAP), CERTAIN is bringing together physicians in vascular surgery, interventional cardiology, and interventional radiology in quality improvement and research activities to improve quality of care in PAD/claudication. Through the Vascular Interventional SCOAP (VI-SCOAP) registry, clinicians are gathering in‐hospital data about the use and outcomes of these different treatments and receiving valuable benchmarking information that they can use to improve the care that they deliver to their patients.
The PAD Study
In addition to VI-SCOAP quality improvement activities, CERTAIN developed a research study that aims to better understand best practices in PAD/claudication treatment. The PAD Study aims to determine for whom, how and when treatments for claudication work best. This comparative effectiveness research study compares the three types of treatment (surgery, endovascular intervention, or medical management) for claudication.
The PAD Study enrolled patients from across Washington State, and the last patient completed follow-up in the fall of 2014. Study participants completed three surveys over the course of one year asking them questions about their health history, quality of life, and improvement (or non-improvement) of their symptoms after treatment. Researchers will also review the medical records of study participants and gather information about their medical condition and history, hospitalizations, and any clinical outcomes from after treatment. The goal of the study is to better understand which treatment method is the safest and most effective for patients with claudication, and to use this information to improve care for patients across Washington State.
The PAD Study is supported by an award received through the Agency for Healthcare Research and Quality.