Themes that Determine Quality of Life in Patients with Peripheral Arterial Disease: A Systematic Review
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The aim of this study was to identify domains that determine quality of life in patients with peripheral arterial disease and find the patient-reported outcome measures that can examine the identified themes.
A systematic review of all the main six databases was undertaken to identify primary qualitative studies reporting on the health and/or quality of life of patients with peripheral arterial disease. The quality of studies was assessed using the Critical Appraisal Skills Program criteria. Findings from the included studies were analysed using framework analysis methodology. The identified themes were mapped against the items/domains of validated patient-reported outcome measures used in patients with peripheral arterial disease.
The systematic review identified eight papers that fulfilled the inclusion criteria. The included papers reported the views of 186 patients with peripheral arterial disease including patients with intermittent claudication, critical ischaemia and amputation secondary to peripheral arterial disease. The overall quality of the included studies was good based on Critical Appraisal Skills Program criteria. Framework analysis identified 35 themes that were divided into six main groups: symptoms, impact on physical functioning, impact on social functioning, psychological impact, financial impact and process of care. The best-fit generic and disease-specific patient-reported outcome measures were the Nottingham Health Profile and the Vascular Quality of Life Questionnaire, respectively. None of the patient-reported outcome measures covered all the themes important to patients with peripheral arterial disease.
The findings from the review identified the important domains that affect patients living with peripheral arterial disease. None of the current generic and disease-specific patient-reported outcome measures provide a comprehensive measure for all themes that impact the daily living of patients with peripheral arterial disease.
Ahmed Aber contributed to the analysis and interpretation of data, drafting of the manuscript and critical revision; Elizabeth Lumley contributed to the analysis and interpretation of data and drafting of the manuscript; Patrick Philips contributed to reviewing the data as well as the analysis and drafting of the manuscript; Helen Buckley Woods performed the searches for the systematic review and assisted in drafting of the manuscript; Georgina Jones contributed to the study conception and design, analysis and interpretation of data, and drafting of the manuscript; and Jonathan Michaels contributed to the study conception and design, drafting of the manuscript and critical revision.
Compliance with Ethical Standards
This study was funded by the UK National Institute for Health Research under the Programme Grants for Applied Research Programme (RP-PG-1210-12009). The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health.
Conflict of interest
Ahmed Aber, Elizabeth Lumley, Patrick Phillips, Helen Buckley Woods, Georgina Jones and Jonathan Michaels have no conflicts of interest directly relevant to the content of this article.
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