H S Khaira1, R Hanger, C P Shearman. 1. Department of Vascular Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, U.K.
Abstract
OBJECTIVE: As intermittent claudication (IC) infrequently progresses to limb loss many clinicians adopt a conservative approach to treatment. Recently percutaneous transluminal angioplasty (PTA) has been applied to patients with IC. If this were to become the first line treatment for IC it would have major implications in terms of hospital facilities as well as cost. A measure is required, therefore, to decide on rationing of limited financial resources. "Quality of life" may be more influential in determining demand on services since objective medical criteria cannot give an insight into the patients feelings of well being. DESIGN: We applied the Nottingham Health Profile, by post, to a group of claudicants and age/sex matched controls. 70% responded from both groups. Claudicants who had recently received intervention were excluded, as were controls complaining of any leg pains on walking. RESULTS: The results showed that claudicants have greater perceived problems in the areas of energy, pain, emotional reactions, sleep, and physical mobility compared to controls (p < 0.05; Mann-Whitney Test). This was reflected by a significantly greater positive response rate to problems with activities of daily living (0.05 > p > 0.02; Chi-square Test) in the claudicant group. CONCLUSION: Because of the cost and resource implications of introducing measures such as PTA to the treatment of vast numbers of patients with IC, we suggest that trials are needed to compare various treatments using quality of life measurements in addition to traditional efficacy/safety parameters.
OBJECTIVE: As intermittent claudication (IC) infrequently progresses to limb loss many clinicians adopt a conservative approach to treatment. Recently percutaneous transluminal angioplasty (PTA) has been applied to patients with IC. If this were to become the first line treatment for IC it would have major implications in terms of hospital facilities as well as cost. A measure is required, therefore, to decide on rationing of limited financial resources. "Quality of life" may be more influential in determining demand on services since objective medical criteria cannot give an insight into the patients feelings of well being. DESIGN: We applied the Nottingham Health Profile, by post, to a group of claudicants and age/sex matched controls. 70% responded from both groups. Claudicants who had recently received intervention were excluded, as were controls complaining of any leg pains on walking. RESULTS: The results showed that claudicants have greater perceived problems in the areas of energy, pain, emotional reactions, sleep, and physical mobility compared to controls (p < 0.05; Mann-Whitney Test). This was reflected by a significantly greater positive response rate to problems with activities of daily living (0.05 > p > 0.02; Chi-square Test) in the claudicant group. CONCLUSION: Because of the cost and resource implications of introducing measures such as PTA to the treatment of vast numbers of patients with IC, we suggest that trials are needed to compare various treatments using quality of life measurements in addition to traditional efficacy/safety parameters.
Authors: Alfa Wenkstetten-Holub; Elisabeth Kandioler-Honetz; Ingrid Kraus; Rudolf Müller; Robert Wolfgang Kurz Journal: Wien Med Wochenschr Date: 2012-06-12
Authors: Ryan J Mays; Ivan P Casserly; Wendy M Kohrt; P Michael Ho; William R Hiatt; Mark R Nehler; Judith G Regensteiner Journal: J Vasc Surg Date: 2011-02-18 Impact factor: 4.268
Authors: Todd J Leutzinger; Panagiotis Koutakis; Matthew A Fuglestad; Hafizur Rahman; Holly Despiegelaere; Mahdi Hassan; Molly Schieber; Jason M Johanning; Nick Stergiou; G Matthew Longo; George P Casale; Sara A Myers; Iraklis I Pipinos Journal: PLoS One Date: 2022-07-13 Impact factor: 3.752
Authors: Farzin Fakhry; Hugo Jp Fokkenrood; Sandra Spronk; Joep Aw Teijink; Ellen V Rouwet; M G Myriam Hunink Journal: Cochrane Database Syst Rev Date: 2018-03-08
Authors: Christine Wann-Hansson; Ingalill Rahm Hallberg; Bo Risberg; Rosemarie Klevsgård Journal: Health Qual Life Outcomes Date: 2004-02-17 Impact factor: 3.186