Abstract
Background: Broadly available digital and mobile health applications (also known as mHealth) have recently gained increasing attention by the vascular community, but very little is known about the dissemination and acceptance of such technologies in certain target populations. The current study aimed to determine the user behaviour and acceptance of such digital technologies amongst patients with peripheral arterial disease (PAD). Methods: A cross-sectional survey of consecutively treated inpatients at 12 university institutions, as well as one non-university institution, was conducted. All admitted patients with symptomatic PAD were surveyed for 30 consecutive days within a flexible timeframe between 1 July and 30 September 2021. The factors associated with smartphone use were estimated via backward selection within a logistic regression model with clustered standard errors. Results: A total of 326 patients participated (response rate 96.3%), thereof 102 (34.0%) were treated for intermittent claudication (IC, 29.2% women, 70 years in median) and 198 were treated for chronic limb-threatening ischaemia (CLTI, 29.5% women, 70 years in median). Amongst all of the patients, 46.6% stated that they had not changed their lifestyle and health behaviour since the index diagnosis (four years in median), and 33.1% responded that they were not aware of the reasons for all of their medication orders. Amongst all those surveyed, 66.8% owned a smartphone (IC: 70.6%, CLTI: 64.1%), thereof 27.9% needed regular user support. While 42.5% used smartphone apps, only 15.0% used mobile health applications, and 19.0% owned wearables. One out of five patients agreed that such technologies could help to improve their healthy lifestyle. Only higher age was inversely associated with smartphone possession. Conclusions: The current survey showed that smartphones are prevalent amongst patients with peripheral arterial disease, but only a small proportion used mobile health applications and a considerable number of patients needed regular user support. Almost half of the patients did not change their lifestyle and one third were not aware of the reasons for their medication orders, emphasising room for improvement. These findings can further help to guide future projects using such applications to identify those target populations that are reachable with digital interventions.
Highlights
IntroductionDuring a ten-year follow up after the index treatment for peripheral arterial disease (PAD), more than 7% of men and 4% of women were diagnosed with incident lung cancer [5]
With more than 230 million patients, peripheral arterial disease (PAD) remains a major public health concern worldwide, owing to limb loss, mortality, and economic burden [1,2].The data derived from large real-world registries suggest that long-term outcomes are devastating due to five-year amputation and death rates of 13–50% in patients with intermittent claudication (IC), and 50–90% with chronic limb-threatening ischaemia (CLTI) [3,4].During a ten-year follow up after the index treatment for PAD, more than 7% of men and 4% of women were diagnosed with incident lung cancer [5]
We summarized the baseline characteristics of the patients with medians and interquartile ranges (IQR) for age and with percentages and a 95% confidence interval (CI) for categorical variables
Summary
During a ten-year follow up after the index treatment for PAD, more than 7% of men and 4% of women were diagnosed with incident lung cancer [5] Against this backdrop, it appears striking that even in high-volume quality improvement registries, the recent prevalence of active smoking as a common modifiable risk factor was reported by more than 44% of the patients [6]. Other important pillars of best medical therapy, such as nutrition, were either not comprehensively covered by most valid guidelines or were prone to show low adherence rates in everyday practice [13] This gap between the evidence-based guideline recommendations and the adherence to life- and limb-saving therapies for PAD patients may be bridged by new ways of patient-centred counselling and education. Many previous efforts dissatisfied in terms of efficacy, cost effectiveness, and scalability [18–20]
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