Skip to main content

Advertisement

SpringerLink
Log in

Leitlinienempfehlungen und Qualitätsindikatoren bei der invasiven Versorgung der peripheren arteriellen Verschlusskrankheit in Deutschland

IDOMENEO-Studie als Beitrag zur Qualitätsentwicklung und Versorgungsforschung in der Gefäßmedizin

Guideline recommendations and quality indicators for invasive treatment of peripheral arterial disease in Germany

The IDOMENEO study for quality improvement and research in vascular medicine

  • Forschung aktuell
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Zahlreiche Empfehlungen in den verfügbaren internationalen Leitlinien zur Diagnostik und Behandlung der peripheren arteriellen Verschlusskrankheit (PAVK) kommen aufgrund fehlender unabhängiger Studiendaten über den Grad von Konsensempfehlungen nicht hinaus. Aufgrund von nicht einheitlich festgelegten Qualitätsindikatoren und fehlenden validen Daten zur Versorgungsrealität ist eine Überprüfung der Leitlinienkonformität der Behandlung zudem erschwert. Dieser Artikel gibt einen kurzen Überblick über die verfügbaren Leitlinienempfehlungen und stellt vor diesem Kontext das mehrstufige multimethodale IDOMENEO-Projekt vor, das sich mit Primärdatenerhebungen (GermanVasc-Register) und Routinedatenerhebungen (BARMER) in der PAVK-Behandlung befasst.

Abstract

Due to the paucity of independent trials, practical guidelines for the diagnosis and treatment of peripheral arterial disease (PAD) contain several recommendations developed by expert consensus. Furthermore, there is a lack of commonly defined quality indicators and valid data on real world treatment. Therefore, it remains challenging to scrutinize if treatment reality is conforming to guideline recommendations. This article aims to give a short overview on existing guideline recommendations. It further aims to introduce the multistage multimethodological IDOMENEO study, utilizing primary registry data (GermanVasc) and health insurance claims data (BARMER) in PAD treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Ahimastos AA, Pappas EP, Buttner PG et al (2011) A meta-analysis of the outcome of endovascular and noninvasive therapies in the treatment of intermittent claudication. J Vasc Surg 54:1511–1521

    Article  Google Scholar 

  2. Behrendt CA, Härter M, Kriston L et al (2017) IDOMENEO – Ist die Versorgungsrealität in der Gefäßmedizin Leitlinien- und Versorgungsgerecht? Gefasschirurgie 22:41–47

    Article  Google Scholar 

  3. Behrendt CA, Heidemann F, Haustein K et al (2016) Percutaneous endovascular treatment of infrainguinal PAOD. Gefasschirurgie 22:17–27

    Article  Google Scholar 

  4. Behrendt CA, Rieß HC, Heidemann F et al (2017) Radiation dosage for percutaneous PAD treatment is different in cardiovascular disciplines: results from an eleven year population based registry in the metropolitan area of Hamburg. Eur J Vasc Endovasc Surg 53:215–222

    Article  Google Scholar 

  5. Bellmunt S, Roque M, Osorio D et al (2014) Healthcare quality indicators of peripheral artery disease based on systematic reviews. Eur J Vasc Endovasc Surg 48:60–69

    Article  CAS  Google Scholar 

  6. Chetter IC, Spark JI, Scott DJ et al (1999) Does angioplasty improve the quality of life for claudicants?: a prospective study. Ann Vasc Surg 13:93–103

    Article  CAS  Google Scholar 

  7. Conte MS, Geraghty PJ, Bradbury AW et al (2009) Suggested objective performance goals and clinical trial design for evaluating catheter-based treatment of critical limb ischemia. J Vasc Surg 50:1462–1473.e1-3

    Article  Google Scholar 

  8. Currie IC, Wilson YG, Baird RN et al (1995) Treatment of intermittent claudication: the impact on quality of life. Eur J Vasc Endovasc Surg 10:356–361

    Article  CAS  Google Scholar 

  9. Diehm C, Schuster A, Allenberg JR et al (2004) High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study. Atherosclerosis 172:95–105

    Article  CAS  Google Scholar 

  10. Engelhardt M, Bruijnen H, Scharmer C et al (2006) Improvement of quality of life six months after infrageniculate bypass surgery: diabetic patients benefit less than non-diabetic patients. Eur J Vasc Endovasc Surg 32:182–187

    Article  CAS  Google Scholar 

  11. Euroqol G (1990) EuroQol – a new facility for the measurement of health-related quality of life. Health Policy (New York) 16:199–208

    Article  Google Scholar 

  12. Fowkes FG, Rudan D, Rudan I et al (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 382:1329–1340

    Article  Google Scholar 

  13. Gerhard-Herman MD, Gornik HL, Barrett C et al (2017) 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 135:e726–e779

    PubMed  Google Scholar 

  14. Goodney PP, Schanzer A, Demartino RR et al (2011) Validation of the Society for Vascular Surgery’s objective performance goals for critical limb ischemia in everyday vascular surgery practice. J Vasc Surg 54:100–108

    Article  Google Scholar 

  15. Guidon M, McGee H (2013) One-year effect of a supervised exercise programme on functional capacity and quality of life in peripheral arterial disease. Disabil Rehabil 35:397–404

    Article  Google Scholar 

  16. Gulati S, Coughlin PA, Hatfield J et al (2009) Quality of life in patients with lower limb ischemia; revised suggestions for analysis. J Vasc Surg 49:122–126

    Article  Google Scholar 

  17. Hedeager Momsen AM, Bach Jensen M, Norager CB et al (2011) Quality of life and functional status after revascularization or conservative treatment in patients with intermittent claudication. Vasc Endovascular Surg 45:122–129

    Article  Google Scholar 

  18. Hunt SM, McKenna SP, McEwen J et al (1981) The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A 15:221–229

    CAS  PubMed  Google Scholar 

  19. Lawall H, Huppert P, Rümenapf G (2015) Leitlinie zur Diagnostik, Therapie und Nachsorge der peripheren arteriellen Verschlusskrankheit, S 3

    Google Scholar 

  20. Malyar N, Fürstenberg T, Wellmann J et al (2013) Recent trends in morbidity and in-hospital outcomes of in-patients with peripheral arterial disease: a nationwide population-based analysis. Eur Heart J 34:2706–2714

    Article  Google Scholar 

  21. McHorney CA, Ware JE Jr., Lu JF et al (1994) The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32:40–66

    Article  CAS  Google Scholar 

  22. Mehta T, Venkata Subramaniam A, Chetter I et al (2003) Disease-specific quality of life assessment in intermittent claudication: review. Eur J Vasc Endovasc Surg 25:202–208

    Article  CAS  Google Scholar 

  23. Morgan MB, Crayford T, Murrin B et al (2001) Developing the Vascular Quality of Life Questionnaire: a new disease-specific quality of life measure for use in lower limb ischemia. J Vasc Surg 33:679–687

    Article  CAS  Google Scholar 

  24. NICE (2012) Peripheral arterial disease: diagnosis and management

    Google Scholar 

  25. Nicolai SP, Kruidenier LM, Rouwet EV et al (2009) The walking impairment questionnaire: an effective tool to assess the effect of treatment in patients with intermittent claudication. J Vasc Surg 50:89–94

    Article  Google Scholar 

  26. Nordanstig J, Gelin J, Hensäter M et al (2011) Walking performance and health-related quality of life after surgical or endovascular invasive versus non-invasive treatment for intermittent claudication – a prospective randomised trial. Eur J Vasc Endovasc Surg 42:220–227

    Article  CAS  Google Scholar 

  27. Nordanstig J, Wann-Hansson C, Karlsson J et al (2014) Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease. J Vasc Surg 59:700–707

    Article  Google Scholar 

  28. Pell JP (1995) Impact of intermittent claudication on quality of life. The Scottish Vascular Audit Group. Eur J Vasc Endovasc Surg 9:469–472

    Article  CAS  Google Scholar 

  29. Society for Vascular Surgery Lower Extremity Guidelines Writing G, Conte MS, Pomposelli FB et al (2015) Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg 61:2S–41S

    Article  Google Scholar 

  30. Tendera M, Aboyans V, Bartelink M‑L et al (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 32:2851–2906

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Gefäßmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    Christian-Alexander Behrendt, Henrik Rieß & Eike Sebastian Debus

  2. Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Martin Härter & Levente Kriston

  3. Fachbereich Informatik, Arbeitsbereich Sicherheit in verteilten Systemen, Universität Hamburg, Hamburg, Deutschland

    Hannes Federrath

  4. Hauptverwaltung, Medizin und Versorgungsforschung, BARMER, Wuppertal, Deutschland

    Ursula Marschall

Authors
  1. Christian-Alexander Behrendt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henrik Rieß
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Härter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Levente Kriston
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hannes Federrath
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ursula Marschall
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eike Sebastian Debus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian-Alexander Behrendt.

Ethics declarations

Interessenkonflikt

C.-A. Behrendt, H. Rieß, M. Härter, L. Kriston, H. Federrath, U. Marschall und E.S. Debus geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Die Autoren dieses Artikels unterstützen die sprachliche Gleichbehandlung der Geschlechter. Aus Gründen der besseren Lesbarkeit wird stellenweise nur eine Form verwendet, obwohl beide Geschlechter gemeint sind: Ärzte und Ärztinnen, Behandler und Behandlerinnen, Patienten und Patientinnen, Teilnehmer und Teilnehmerinnen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Behrendt, CA., Rieß, H., Härter, M. et al. Leitlinienempfehlungen und Qualitätsindikatoren bei der invasiven Versorgung der peripheren arteriellen Verschlusskrankheit in Deutschland. Bundesgesundheitsbl 61, 218–223 (2018). https://doi.org/10.1007/s00103-017-2676-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00103-017-2676-9

Schlüsselwörter

Keywords

Search

Navigation