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Patterns and determinants of use of pharmacological therapies for intermittent claudication in PAD outpatients: results of the IDOMENEO study.
- Source :
-
International angiology : a journal of the International Union of Angiology [Int Angiol] 2017 Jun; Vol. 36 (3), pp. 254-260. Date of Electronic Publication: 2016 Sep 06. - Publication Year :
- 2017
-
Abstract
- Background: Peripheral arterial disease (PAD) usually presents with intermittent claudication (IC). The aim of the present study was to assess, in clinical practice, the pattern of use of pharmacological therapies for IC in stable PAD outpatients.<br />Methods: A propensity analysis was performed using data from the IDOMENEO study, an observational prospective multicenter cohort study. The association between any pharmacological symptomatic IC therapy with different variables was investigated using generalized linear mixed models with pharmacological therapy as response variable and binomial error.<br />Results: Study population: 213 patients, male sex 147 (69.0%), mean age 70.0±8.6 years. Only 36.6% was under pharmacological treatment for IC, being cilostazol the most used medication (21.6%). Univariate analysis showed a probability of a patient of being assigned to any pharmacological symptomatic IC therapy of 67.0% when Ankle-Brachial Index (ABI) <0.6 and 29.8% when ABI>0.6 (P=0.0048), and a propensity to avoid pharmacological treatment for patients with a high number of drugs to treat cardiovascular risk factors (probability of 55.2% for <4 drugs and 19.6% for >4 drugs, P=0.0317). Multivariate analysis confirmed a higher probability of assigning treatment for ABI<0.6 (P=0.0274), and a trend to a lower probability in patients under polypharmacy (>4 drugs: OR=0.13, P=0.0546).<br />Conclusions: In clinical practice, only one third of stable outpatients with IC used symptomatic pharmacological therapy for IC. We found a propensity of clinicians to assign any symptomatic pharmacological IC therapy to patients with lower values of ABI and a propensity to avoid this kind of treatment in patients under polypharmacy.
- Subjects :
- Aged
Ankle Brachial Index
Cilostazol
Female
Humans
Italy
Male
Middle Aged
Multivariate Analysis
Outpatients
Patient Compliance
Polypharmacy
Prospective Studies
Risk Factors
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Intermittent Claudication drug therapy
Peripheral Arterial Disease complications
Platelet Aggregation Inhibitors therapeutic use
Tetrazoles therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1827-1839
- Volume :
- 36
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International angiology : a journal of the International Union of Angiology
- Publication Type :
- Academic Journal
- Accession number :
- 27598470
- Full Text :
- https://doi.org/10.23736/S0392-9590.16.03734-2