mHealth for patients with Peripheral Artery Disease: Development of Walk-A-Cise mobile phone application to TRL7

行走时小腿疼痛是腿部血液供应狭窄或阻塞（称为外周动脉疾病）患者的一种非常常见的症状，约有10%的60岁以上的人会受到影响。治疗应包括有监督的运动疗法，通常在医院内每周2小时，持续12周。这已被证明可以改善步行距离并减少手术的需要。目前，英国只有不到一半的医院提供这些课程，因此患者只是被告知回家走路。这种方法的效果不到一半。最近的一项血管外科优先权设定研究表明，我们需要改善运动疗法的可及性和提供，改善对这种疾病的教育，并使患者更容易获得帮助。为了提高运动疗法的可用性，我们需要一种新的服务方式。有很好的证据表明，智能手表有助于改善步行距离，因为患者可以看到它们的改善。其他疾病领域已经使用移动的电话应用程序来提供患者教育和视频，这已被证明可以减少住院人数。因此，我们开发了Walk-A-Cise移动的电话应用程序，用于外周动脉疾病患者，目前正在3家NHS医院进行测试。这款应用使用GPS跟踪来监测步行距离，然后医疗保健专业人员可以看到数据。来自患者和医疗保健专业人员的反馈强调了进一步开发该应用所需的一些关键领域。这将改善应用程序的功能，以便可以进行一些特定的测试，以便可以通过应用程序完成调查，因此患者可以通过视频加入锻炼课程，因此患者可以在需要时与医疗保健专业人员联系。通过构建患者和医疗保健专业人员想要使用的应用程序，易于使用，并包含一系列的选择，让患者获得教育和改善他们的行走，这将增加患者长期使用该应用程序的机会，因此不需要来医院预约，并降低需要手术的机会。保持人们移动的也将减少孤立和对他人的依赖。它还将允许更广泛地获得护理，减少这些通常来自较低社会经济群体的患者的医疗保健不平等。

Pain in their lower legs on walking is a very common symptom for patients with narrowing or blockages to the blood supply to the legs (termed peripheral arterial disease) and affects approximately 10% of people over the age of 60\. Treatment should include supervised exercise therapy which is usually done as a class within the hospital for 2 hours per week for 12 weeks. This has been shown to improve walking distance and reduce the need for surgery.Currently less than half of UK hospitals provide these classes, therefore patients are just told to go home and walk. This approach is less than half as effective. A recent priority setting exercise in vascular surgery determined that we need to improve access to and provision of exercise therapy, improve education around this disease, and make it easier for patients to get help.In order to improve the availability of exercise therapy we need a new way of delivering the service. There is good evidence that smart watches help to improve walking distance as patients can see their improvement. Other disease areas have used mobile phone applications to provide patient education and videos, which have been shown to reduce hospital admissions. We therefore developed the Walk-A-Cise mobile phone application for patients with peripheral arterial disease which is currently undergoing testing in 3 NHS hospitals. This uses GPS tracking to monitor walking distance, and the data can then be seen by healthcare professionals.Feedback from patients and healthcare professionals has highlighted some key areas that are needed to develop the app further. This will improve the functions of the app so that some specific tests can be done, so that surveys can be completed through the app, so patient can join an exercise class through videos, and so patients can get in touch with their healthcare professional when needed.By building an app that patients and healthcare professionals want to use, is easy to use, and contains a range of options for patients to get education and improve their walking, this will increase the chance of patients using the app in the long-term, and therefore not need to come to the hospital for appointments and lower the chance of needing surgery. Keeping people mobile will also reduce isolation and dependence on others. It will also allow wider access to care reducing healthcare inequality in these patients whom are often from lower socioeconomic groups.