Work

Closing GDMT Gaps in PAD Patients During Supervised Exercise Therapy

Year: 2025

Type: article

Abstract: BACKGROUND: Peripheral artery disease carries high cardiovascular risk. Although supervised exercise therapy (SET) improves function, uptake of guideline-directed medical therapy (GDMT) is inconsistent in practice. PROJECT RATIONALE: We observed frequent missed opportunities for GDMT among patients with peripheral artery disease who were referred to a high-touch SET program. PROJECT SUMMARY: In phase 1 of a multiphase quality improvement initiative, we retrospectively analyzed 60 consecutive SET referrals (January 2023-March 2025); 41 patients had complete follow-up and were included in the final analysis. At follow-up, 51% were on GDMT, 29% had never started, and 20% had discontinued. Patients on GDMT showed the most favorable physiologic change according to metabolic equivalents of task (+0.33), whereas non-GDMT groups declined (-0.18 to -0.27). Symptom relief and walking improvement were common across groups but were most consistent with GDMT. Findings will inform phase 2 interventions: electronic medical record prompts, provider feedback, and patient outreach. TAKE-HOME MESSAGE: Substantial GDMT care gaps persist even within SET. Embedding clinical decision support, feedback, and outreach is the next step to translate functional gains into durable vascular protection.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105615

Authors: S.M. Muir, A.R. Albers

Institutions: OhioHealth, Riverside Methodist Hospital

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: $850