Perspectives on Lower Extremity Peripheral Artery Disease: A Qualitative Study of Early Diagnosis and Treatment and the Impact of Health Disparities.

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  • Additional Information
    • Source:
      Publisher: Mary Ann Liebert Country of Publication: United States NLM ID: 101481266 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1942-7905 (Electronic) Linking ISSN: 19427891 NLM ISO Abbreviation: Popul Health Manag Subsets: MEDLINE
    • Publication Information:
      Original Publication: New Rochelle, NY : Mary Ann Liebert
    • Subject Terms:
      Ethnicity* ; Peripheral Arterial Disease*/diagnosis ; Peripheral Arterial Disease*/therapy ; Peripheral Arterial Disease*/epidemiology; Humans ; Minority Groups ; Lower Extremity/blood supply ; Early Diagnosis
    • Abstract:
      Lower-extremity peripheral artery disease (PAD), the accumulation of atherosclerotic plaque in the arteries of the legs, causes substantial morbidity and mortality. Frequent under- and delayed diagnosis result in poor outcomes, disproportionately affecting individuals from racial and ethnic minority groups. To understand barriers to early detection and treatment and factors contributing to disparities, American Medical Group Association (AMGA) conducted roundtable discussions and semistructured interviews in 2021. Eighteen participants discussed PAD evaluation, diagnosis, early medical management, and disparities in care. A qualitative case study approach and data reduction methods were used to generate themes, draw conclusions, and make actionable recommendations. Identified themes included lack of (1) prioritization of PAD for population health; (2) engagement of primary care providers in early evaluation and referral; (3) "ownership" of lower-extremity PAD within health systems; and (4) focus on disparities in care. Participant solutions included (1) financial impact of early PAD management, in the context of value-based payment; (2) embedding an advanced practice provider into a vascular surgery practice to facilitate evaluation and provide medical therapy; and (3) leveraging care coordination, multidisciplinary clinics, and telehealth technology to provide comprehensive care for patients with PAD and address disparities. A deliberate focused effort is necessary to close gaps and the accompanying disparities in early evaluation, diagnosis, and treatment for people with lower-extremity PAD. The authors describe 3 models that can be emulated to improve care for this high-risk population. With improved reimbursement and better medical therapies, now is the time to focus on early diagnosis and management of PAD.
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    • Contributed Indexing:
      Keywords: peripheral artery disease; primary care; screening; treatment; vascular medicine
    • Publication Date:
      Date Created: 20231110 Date Completed: 20231201 Latest Revision: 20231208
    • Publication Date:
      20231215
    • Accession Number:
      PMC10698760
    • Accession Number:
      10.1089/pop.2023.0095
    • Accession Number:
      37948553