The Minnesota Regional Peripheral Arterial Disease Screening Program: toward a definition of community standards of care
The Minnesota Regional Peripheral Arterial Disease Screening Program: toward a definition of community standards of care
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DOI：
10.1177/1358836x0100600204
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发表时间：
2001-05-01
影响因子：
3.5
通讯作者：
Hunninghake, DB
中科院分区：
文献类型：
--
作者：
Hirsch, AT;Halverson, SL;Hunninghake, DB
明尼苏达州地区外周动脉疾病筛查计划旨在确定社区PAD检测工作的有效性，评估疾病特异性和健康相关的发病率，评估PAD知晓率，并确定动脉粥样硬化疾病危险因素的程度及其管理强度。通过大众媒体招募目标人群，目标人群为50岁以上的个体和患有下肢疼痛的患者。筛选包括评估踝臂指数、血压、空腹血脂谱，以及使用经验证的工具检测症状性跛行（通过改良的WHO-爱丁堡跛行问卷）、步行障碍（步行障碍问卷- WIQ）、生活质量（MOS SF-36）、PAD意识和PAD药物治疗干预的强度。PAD定义为任何踝臂指数小于或等于0.85或有下肢血运重建史。该项目评估了347名个体，确定了92名PAD受试者和255名无PAD受试者，检出率为26.5%。与非PAD受试者相比，PAD受试者年龄较大，血压往往较高，行走障碍明显，健康相关生活质量受损。目前的烟草使用率很低。在PAD队列中，降脂、雌激素替代、抗血小板、抗高血压药物和运动疗法未得到充分利用。这些社区确定的患者对外周动脉疾病的认识较低。这一方案表明，在社区内可以有效地识别PAD患者，但目前的医疗保健标准很低。这些数据可以帮助未来的PAD意识，教育和治疗计划的发展。
The Minnesota Regional Peripheral Arterial Disease Screening Program was designed to define the efficacy of community PAD detection efforts, to assess the disease-specific and health-related morbidity, to assess PAD awareness rates, and to determine the magnitude of atherosclerosis disease risk factors and the intensity of their management. The target population was recruited via mass media efforts directed at individuals over 50 years of age and those with leg pain with ambulation. Screening sessions included assessments of the ankle-brachial index, blood pressure, fasting lipid profile, and use of validated tools to detect symptomatic claudication (by the Modified WHO-Edinburgh Claudication Questionnaire), walking impairment (Walking Impairment Questionnaire - WIQ), quality of life (MOS SF-36), PAD awareness, and the intensity of PAD medical therapeutic interventions. PAD was defined as any ankle-brachial index less than or equal to0.85 or a history of lower extremity revascularization. The program evaluated 347 individuals and identified 92 subjects with PAD and 255 subjects without PAD, yielding a detection rate of 26.5%. Individuals with PAD were older, tended to have higher blood pressures, and had a significant walking impairment and an impaired health-related quality of life compared with the non-PAD subjects. Current rates of tobacco use were low. Lipid-lowering, estrogen replacement, anti-platelet, and anti hypertensive medications and exercise therapies were underutilized in the PAD cohort. Peripheral arterial disease awareness was low in these community-identified patients. This Program demonstrated that individuals with PAD can be efficiently identified within the community, but that current standards of medical care are low. These data can assist in the future development of PAD awareness, education, and treatment programs.