American Heart Association Calls Attention to Role of Patient-Reported Outcomes in Peripheral Artery Disease

Kim G. Smolderen, PhD

A new document from the American Heart Association (AHA) is providing clinicians with an updated roadmap to patient-focused care for people with peripheral artery disease (PAD).

Authored by a team of 8 on behalf of the AHA Council on Peripheral Vascular Disease and Council on Lifestyle and Cardiometabolic Health, the scientific statement shines a spotlight on how a person’s experience of symptoms can lead to improved management of PAD and places a special emphasis on the role and incorporation of patient-reported outcomes (PROs) in care of PAD.

“The person living with peripheral artery disease is the authority on the impact it has on their daily life. Our treatment must be grounded in their lived experiences and go beyond the clinical measures of how well blood flows through the arteries,” said Vice Chair and lead author of the statement writing group Kim G. Smolderen, PhD, a clinical psychologist and codirector of the Vascular Medicine Outcomes Research lab at Yale University, in a statement from the AHA. “We have spent years developing and validating standardized instruments to capture people’s experiences in a reliable and sensitive way. We are now at a point where we can start integrating this information into real-world care, through pilot programs that can develop quality benchmarks for different phenotypes of patients with PAD and the types of treatments they undergo, as seen from their perspective.”

Published on October 13, the 12 page-document opens by outlining the state of the field in health status assessment for PAD, noting the detrimental impact of PAD on quality of life and calling attention to the growing mass of data related to development of patient-reported outcome measures (PROMs) to better leverage patient-reported outcomes in care. Atop the second page of the document is a graph outlining specific concepts, definitions, and providing examples for patient-reported outcomes, PROMs, and PRO-Based performance measures (PRO-PMs). The following age provides an additional graphic outlining the roadmap for the development of PRO-PMs in PAD.

In the aforementioned statement from the AHA, the organization highlights 4 specific benefits of PROMs, including:

• Improving understanding of the patient’s lived experience with PAD.
• Improving patients’ self-management of symptoms and medical needs.
• Standardizing quality performance benchmarks for practices that care for people with PAD.
• Providing relevant feedback to determine treatment changes or needs.

Further into the scientific statement, the writing group points out additional considerations for future development of PRO-PMs for advancing quality of PAD care and outcomes. Before concluding, the writing group calls attention to current challenges and future direction for optimizing management of PAD, noting that, despite the enthusiasm, the development of systematic PROs for people with PADs would benefit from a collaborative effort in terms of research and involvements from professional organizations and stakeholders. Other members of the statement writing group included Chair Carole Decker, PhD, RN, Olamide Alabi, MD, Tracie C. Collins, MD, MPH, MS, Bernard P. Dennis, BA, Philip P. Goodney, MD, Carlos Mena-Hurtado, MD, and John A. Spertus, MD, MPH.

“This roadmap highlights a paradigm shift that places the patient experience front and center, which is a departure from the status quo. It is provocative to now place the lived experience with the disease at the forefront, engaging people with PAD to provide information that holds health systems and practitioners accountable as to whether high-quality care was delivered, in addition to assessing the safe and effective delivery of current evidence-based treatments,” Smolderen added.

This article, “Advancing Peripheral Artery Disease Quality of Care and Outcomes Through Patient-Reported Health Status Assessment: A Scientific Statement From the American Heart Association,” was published in Circulation.