Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Medical Resource Consumption and Quality of Life in Peripheral Arterial Disease in Korea: PAD Outcomes (PADO) Research

  • Rha, Seung-Woon (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital) ;
  • Choi, Seung-Hyuk (Division of Cardiology, Department of Internal Medicine, Samsung Medical Center) ;
  • Kim, Doo-Il (Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Jeon, Dong Woon (Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital) ;
  • Lee, Jae-Hwan (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Hong, Kyung-Soon (Division of Cardiology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital) ;
  • Cha, Tae-Joon (Division of Cardiology, Department of Internal Medicine, Kosin University, Gospel Hospital) ;
  • Cho, Jang-Hyun (Division of Cardiology, Department of Internal Medicine, St. Carollo Hospital) ;
  • Lee, Sang Kon (Division of Cardiology, Department of Internal Medicine, Ulsan University Hospital) ;
  • Park, Yong Hwan (Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Woo Jung (Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital) ;
  • Kim, Hyun-Joo (Outcomes Research and Real World Data, Pfizer Pharmaceuticals Korea Ltd.) ;
  • Kim, Young-Joo (Outcomes Research and Real World Data, Pfizer Pharmaceuticals Korea Ltd.) ;
  • Lee, Juneyoung (Department of Biostatistics, Korea University College of Medicine) ;
  • Choi, Donghoon (Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University Health System)
  • Received : 2017.11.07
  • Accepted : 2018.04.10
  • Published : 2018.09.30
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Abstract

Background and Objectives: We aimed to investigate the history of medical resource consumption and quality of life (QoL) in peripheral arterial disease (PAD) patients in Korea. Methods: This was a prospective, multi-center (23 tertiary-hospitals, division of cardiology), non-interventional study. Adult patients (age ${\geq}20 years$) suffering from PAD for the last 12-month were enrolled in the study if they met with any of following; 1) ankle-brachial index (ABI) ${\leq}0.9$, 2) lower-extremity artery stenosis on computed tomography angiography ${\geq}50%$, or 3) peak-systolic-velocity-ratio (PSVR) on ultrasound ${\geq}2.0$. Medical chart review was used to assess patient characteristics/treatment patterns while the history of medical resource consumption and QoL data were collected using a patient survey. QoL was measured using EuroQoL-5-dimensions-3-level (EQ-5D-3L) score system, and the factors associated with QoL were analyzed using multiple linear regression analysis. Results: This study included 1,260 patients (age: 69.8 years, male: 77.0%). The most prevalent comorbidities were hypertension (74.8%), hyperlipidemia (51.0%) and diabetesmellitus (50.2%). The 94.1% of the patients took pharmacotherapy including aspirin (76.2%), clopidogrel (53.3%), and cilostazol (33.6%). The 12.6% of the patients were receiving smoking cessation education/pharmacotherapy. A considerable number of patients (500 patients, 40.0%) had visit history to another hospital before diagnosis/treatment at the current hospital, with visits to orthopedic units (50.4%) being the most common. At the time, 29% (or higher) of the patients were already experiencing symptoms of critical limb ischemia. Baseline EQ-5D index and EQ VAS were $0.64{\pm}0.24$ and $67.49{\pm}18.29$. Factors significantly associated with QoL were pharmacotherapy (B=0.05053; p=0.044) compared to no pharmacotherapy, and Fontaine stage improvement/maintain stage I (B=0.04448; p<0.001) compared to deterioration/maintain stage II-IV. Conclusions: Increase in disease awareness for earlier diagnosis and provision of adequate pharmacotherapy is essential to reduce disease burden and improve QoL of Korean PAD patients.

Keywords

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