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供血变窄或阻塞的患者的常见症状(称为外周动脉疾病)，60岁以上的人中约有10%会受到影响。治疗应该包括有监督的运动疗法，通常是在医院内以班级的形式进行，每周2小时，持续12周。这已经被证明可以延长步行距离，减少手术的需要。目前，英国只有不到一半的医院提供这种课程，因此患者只被告知回家走路。这种方法的效果还不到一半。最近血管外科的一项优先事项设定活动决定了我们需要改善运动疗法的获得和提供，改善关于这种疾病的教育，并使患者更容易获得帮助。为了提高运动疗法的可用性，我们需要一种新的提供服务的方式。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。其他疾病区也使用手机应用程序提供患者教育和视频，这已被证明可以减少入院人数。因此，我们为外周动脉疾病患者开发了Walk-A-Cise移动电话应用程序，目前正在3家NHS医院进行测试。这款应用使用GPS跟踪来监控步行距离，然后医疗专业人员可以看到数据。患者和医疗专业人员的反馈突出了进一步开发这款应用所需的一些关键领域。这将改进该应用程序的功能，以便可以完成一些特定的测试，以便通过该应用程序完成调查，以便患者可以通过视频加入锻炼课程，从而使患者可以在需要时与他们的医疗专业人员联系。通过构建一个患者和医疗专业人员想要使用的、易于使用的应用程序，并包含患者接受教育和改善他们的行走的一系列选项，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。让人们保持机动性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，减少这些患者的医疗不平等，这些患者往往来自较低的社会经济群体。

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.