Barriers to screening and diagnosis of peripheral artery disease by general practitioners

Peripheral artery disease (PAD) is a strong predictor of cardiovascular morbidity and mortality yet it is under-recognised and undertreated. General practitioners (GPs) are best positioned to detect patients with PAD. This article investigates awareness of PAD by GPs; the prevalence of screening for...

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Bibliographic Details
Published in:Vascular medicine (London, England) England), 2013-12, Vol.18 (6), p.325-330
Main Authors: Haigh, Kate Jamilla, Bingley, John, Golledge, Jonathan, Walker, Philip J
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Ankle Brachial Index
Australia - epidemiology
Brachial Artery - physiopathology
Cross-Sectional Studies - methods
General Practitioners
Humans
Middle Aged
Peripheral Arterial Disease - diagnosis
Peripheral Arterial Disease - epidemiology
Prevalence
Risk Factors
Young Adult
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Summary:Peripheral artery disease (PAD) is a strong predictor of cardiovascular morbidity and mortality yet it is under-recognised and undertreated. General practitioners (GPs) are best positioned to detect patients with PAD. This article investigates awareness of PAD by GPs; the prevalence of screening for PAD and tools used for screening and diagnosis, in particular the ankle–brachial index (ABI); and the barriers to PAD screening and measurement of the ABI in the general practice setting. A cross-sectional survey of primary care practitioners was conducted between September 2011 and March 2012. A mail-out survey was distributed to 1120 GPs practising in Queensland, Australia: 287 (26%) responded; 61% of GPs reported screening for PAD; 58% of GPs reported ‘never’ measuring the ABI; and 70% reported using arterial duplex ultrasound as their first-line diagnostic tool. Equipment availability, time constraints and lack of training and skills were identified as the most significant barriers to screening and ABI testing. In conclusion, there are deficits in the utilisation of guideline recommendations relating to PAD screening and diagnosis by Australian GPs. Our data suggest that earlier detection of PAD may be achieved through GP education combined with increased access to ABI equipment or the availability of a more time-efficient test.
ISSN:1358-863X
1477-0377
DOI:10.1177/1358863X13505673