Focus group study of factors relevant to treatment decisions and experiences among patients with symptomatic peripheral artery disease

Matthew A Corriere; Gloria Y Kim; Mary E Byrnes; Anne Sales; Donna Keith; Edward H Ip; Gregory L Burke; Derrick S Boone; Douglas Easterling

doi:10.1016/j.jvs.2022.06.023

Focus group study of factors relevant to treatment decisions and experiences among patients with symptomatic peripheral artery disease

J Vasc Surg. 2022 Nov;76(5):1316-1324. doi: 10.1016/j.jvs.2022.06.023. Epub 2022 Jul 19.

Authors

Matthew A Corriere¹, Gloria Y Kim², Mary E Byrnes², Anne Sales³, Donna Keith⁴, Edward H Ip⁵, Gregory L Burke⁵, Derrick S Boone⁶, Douglas Easterling⁵

Affiliations

¹ Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI; Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, MI. Electronic address: mcorrier@med.umich.edu.
² Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI; Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, MI.
³ Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI.
⁴ Department of Vascular and Endovascular Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
⁵ Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
⁶ School of Business, Wake Forest University, Winston-Salem, NC.

PMID: 35863556
DOI: 10.1016/j.jvs.2022.06.023

Abstract

Background: Clinical guidelines recommend shared decision-making for treatment of peripheral artery disease (PAD), which requires understanding of patient perspectives and preferences. We conducted a focus group study of patients with symptomatic PAD to identify factors important and relevant to treatment choices, and to characterize aspects of the health care process that contribute to positive vs negative experiences apart from the specific treatment(s) received.

Methods: Participants were recruited from an academic medical center over 2 years using a purposeful sampling approach based on a clinical diagnosis of symptomatic PAD (either claudication or chronic limb-threatening ischemia [CLTI]) confirmed by the abnormal ankle or toe brachial index. Focus groups were led by a nonphysician moderator, consisted of 5 to 12 participants, and were conducted separately for patients with CLTI and claudication. Audio recordings converted to verbatim transcripts were used for qualitative analysis.

Results: A total of 51 patients (26 with CLTI and 25 with claudication) were enrolled and participated in focus groups. Major themes identified related to treatment preferences and decisions included specific interventions under consideration, the chance of technical success versus failure, anticipated degree of symptom improvement, outcome durability, and risk. Major themes related to the process of care included decision-making input, provider communication and trust, the timeline from diagnosis to definitive treatment, and compartmentalized care (including different venues of care).

Conclusions: The results provide insights into patient preferences, perspectives, and experiences related to PAD treatment. These observations can be used to inform patient-centered approaches to shared decision-making, communication, and assessment of PAD treatment outcomes.

Keywords: Chronic limb-threatening ischemia; Decision-making; Focus groups; Intermittent claudication; Peripheral arterial disease; Shared.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Focus Groups
Humans
Intermittent Claudication / diagnosis
Intermittent Claudication / therapy
Ischemia* / diagnosis
Ischemia* / therapy
Lower Extremity / blood supply
Peripheral Arterial Disease* / diagnosis
Peripheral Arterial Disease* / therapy