I.C. Cohen1, M. Alagna2, M. Reilly2,5, C. Iroz3,5, J.K. Johnson3,4,5, K.J. Ho2 1Feinberg School Of Medicine – Northwestern University, Chicago, IL, USA 2Northwestern University, Department Of Surgery, Division Of Vascular Surgery, Chicago, IL, USA 3Northwestern University, Department Of Surgery, Chicago, IL, USA 4University Of North Carolina At Chapel Hill, Department Of Surgery, Chapel Hill, NC, USA 5Northwestern University, Quality Improvement, Research, And Education In Surgery (NQUIRES), Chicago, IL, USA
Introduction: Lower extremity peripheral artery disease (PAD) is a highly prevalent chronic disease that carries increased risk of cardiovascular death, functional deficits, and limb loss. Patient knowledge of PAD has been shown to be lower than other cardiovascular diseases. Clinician perspectives on PAD education methods have not been well studied. We conducted a qualitative study of multidisciplinary clinicians who treat patients with PAD to understand their PAD education strategies and their perceptions of a PAD video education tool.
Methods: In this single-center qualitative study, we conducted semi-structured interviews with vascular surgeons, vascular nurse practitioners, and primary care physicians about their current PAD education strategies. Clinicians then watched a 20-minute patient-oriented PAD video education tool. A second round of semi-structured interviews was conducted after the video to assess perceptions of its acceptability, appropriateness, and feasibility. Codes were developed using both inductive and deductive methods. Qualitative analysis was conducted in dyads to refine codes and identify overarching themes.
Results: There were 7 participants, including 2 vascular surgeons, 4 vascular nurse practitioners, and 1 primary care physician. Four key themes were identified: (1) clinicians value interpersonal discussions, building longitudinal relationships, providing individualized education, and creating the space for patients to ask questions; (2) clinicians report barriers to PAD education that are experienced by both patients (e.g., poor health literacy and risk factor management) and clinicians (e.g., limited time for education); (3) acceptability of the video education tool was high, as clinicians appreciated the content and comprehensibility of the video as well as the ability for patients to rewatch at home, but were concerned about implementation and time management; and (4) goals for better PAD education included more time for discussion with patients and inclusion of multidisciplinary teams such as nutritionists and smoking cessation counselors.
Conclusion: Clinicians value individualizing patient-centric PAD education and prioritizing opportunities for patients to ask questions. Clinicians felt that the PAD video education tool should not replace direct discussions between patients and clinicians, but could be a valuable addition to PAD patient education interventions in select settings.