Work

Patient activation levels are low in patients undergoing revascularization for lower limb arterial disease but do not correlate with 30-day clinical outcomes

Year: 2025

Type: article

Abstract: Background Patient activation refers to the ability of individuals to engage in their healthcare. Studies have shown a positive association between patient activation and improved clinical outcomes in some patient groups. Objective This study aims to characterise the level of activation in patients with peripheral arterial disease (PAD) undergoing revascularisation procedures and to determine if patient activation is associated with 30-day clinical outcomes. Methods This is a single-centre, prospective, observational study (ethics reference: 23/NS/0078). Patients undergoing planned lower limb revascularisation within a 5-month period were invited to participate and to complete the Patient Activation Measure (PAM) survey prior to their surgery. Responses were scored on a Likert scale and an overall PAM score produced between 1 and 100 (lowest to highest activation). The relationship between baseline characteristics and PAM score was evaluated using linear regression. Spearman's rank-order correlation and logistic regression was conducted to examine the relationship between PAM scores and 30-day clinical outcomes. Results Eighty patients were included in this study. The median age was 71 years (IQR 3 years) and 70% were male. The median PAM score was 53 (IQR 16). Current smokers and patients with type 2 diabetes had significantly lower PAM scores than non-smokers (p<0.05) and non-diabetics (p<0.001). Multivariate regression revealed age and type 2 diabetes were significant predictors of PAM score. There was no association between PAM score and any 30-day clinical outcomes. Conclusions Patient activation is low in our sample of PAD patients undergoing revascularisation procedures. This suggests more work is needed to educate and engage patients in self-management of this long-term condition. Patient activation was not correlated with 30-day clinical outcomes, but further research is warranted to determine whether it is related to medium or long-term clinical outcomes.

Source: JVS-Vascular Insights

DOI: 10.1016/j.jvsvi.2025.100266

Authors: Georgina Harmer, Francesca Siracusa, Sandip Nandhra, Joseph Shalhoub

Institutions: Imperial College Healthcare NHS Trust, Imperial College London, Freeman Hospital, Newcastle University

Language: English

Topic: Peripheral Artery Disease Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000