Patients' Perspectives of Factors That Support the Management of Peripheral Arterial Disease for Improved Outcomes

• Patients' perspective of the factors that affects their decisions regarding management of their PAD [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  Qualitative interview that will collect patients perspectives and will be analyzed for thoughts, opinions, feelings, and concepts.
  
  

• Quantitative Morinsky's Medication adherence survey [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  Morinsky's Medication adherence survey will be administered at baseline and one year to assess self report medication adherence.
  
  
• Quantitative PAQ health status survey [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  PAQ health status will be administered at the initial visit as well as the last one-on-one interview to assess disease specific health status.
  
  
• Quantitative EQ-5D health status survey [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  survey will be administered at the initial visit as well as the last one-on-one interview to assess overall health status.
  
  
• Quantitative Stage of Change Survey [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  Stage of Change motivational survey will be administered at the initial visit as well as the last one-on-one interview to assess patients motivational status.
  
  
• Quantitative SEAMS survey [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  SEAMS self efficacy survey will be administered at the initial visit as well as the last one-on-one interview to assess patient self efficacy to adhere to medication treatment.
  
  

Cardiovascular Diseases (CVD) affects as many lives each year as cancer, chronic lower respiratory diseases, accidents and diabetes mellitus combined. One in three American adults (about 80,000,000) has one or more types of cardiovascular disease. Prevention and management of CVD is a public health goal, yet, it remains a major challenge. Even hypertension, which is easily detected and usually controllable, has only a 50 percent control rate.

Peripheral Arterial Disease (PAD) is one type of CVD, which affects about eight million Americans and is also associated with significant morbidity and mortality. PAD increases with age and disproportionately affects African Americans. Interestingly, despite its prevalence and cardiovascular risk implications, only 20 to 30 percent of PAD patients are undergoing treatment.

Medical management of these diseases has substantially contributed to improved morbidity and mortality. However, for the medical therapies to be successful the patients need to take their medications and adjust their lifestyles, as prescribed. Overall, "typical adherence rates for the general population are about 50 percent for medications and are much lower for lifestyle prescriptions and other more behaviorally demanding regimens". Few studies have investigated the reactions and thoughts regarding the efficacy of therapies/interventions from the perspective of the participants. Meta analyses on adherence have also revealed that the patients' perspectives are often absent and that present adherence theories are more successful in explaining non-adherence than improving adherence. Therefore, it is important to understand, from the perspective of the patient; the factors they believe improve their cardiac outcomes with an emphasis on the adherence to prescribed therapies.

This qualitative study will investigate the question: What are patients' perspectives of factors that support the management of their cardiovascular condition to improve outcomes in a Peripheral Arterial Disease population? Cardiac outcomes of interest are health status defined by symptom burden, functional status, and health related quality of life, patients' perception of the quality of care that they receive, and the experience of living with PAD.