Top Things to Know: Advancing PAD Quality of Care and Outcomes Through Patient-Reported Health Status Assess
Published: October 13, 2022
Prepared by Kim Smolderen, PhD, Clinical Psychologist and Outcomes Researcher - Lead
- Peripheral artery disease (PAD) affects over 8.5 million individuals in the U.S. and significantly impacts their risk of cardiovascular events, including death.
- Most patients with PAD continue to live and experience impact on their day-to-day lives, including their functioning and quality of life, especially when individuals experience symptoms.
- PAD symptoms can range from pain while walking to ischemic rest pain, non-healing wounds, and gangrenous tissue, leading to amputations in the lower extremities.
- Managing cardiovascular risk and PAD symptoms are pillars of PAD chronic disease management and require a tailored and patient-centered approach.
- A way to capture experiences of PAD and treatment effects as seen from the patients’ perspective is the use of patient-reported outcomes measures (PROMs).
- PROMs for PAD have been used in the research setting so far to evaluate treatment effects or document the disease trajectories of patients.
- Spurred by the Centers for Medicare and Medicaid Services and the National Quality Forum, PROMs are increasingly being integrated into definitions of what it means to deliver patient-centered high-quality clinical care. Leveraging PROMs for performance evaluation is referred to as PRO-based performance measures (PRO-PMs).
- Using the National Quality Forum framework for PRO-PM development, this statement defines measurement goals for PAD care, offers an overview of the benefits of integrating PROMs assessment as part of the clinical care delivery, and provides a roadmap for the development of PRO-PMs in PAD for the advancement of quality of PAD care and outcomes.
- Health system requirements, competencies to administer and interpret PRO-PMs, and quality and ethical considerations for using PRO-PMs are discussed.
- This statement also offers four pilot test PRO-PMs for patients with symptomatic PAD (without critical limb ischemia).
Citation
Smolderen KG, Alabi O, Collins TC, Dennis B, Goodney PP, Mena-Hurtado C, Spertus JA, Decker C; on behalf of the American Heart Association Council on Peripheral Vascular Disease and Council on Lifestyle and Cardiometabolic Health. Advancing peripheral artery disease quality of care and outcomes through patient-reported health status assessment: a scientific statement from the American Heart Association [published online ahead of print] October 13, 2022. Circulation. doi: 10.1161/CIR.0000000000001105