Patient activation levels are low in patients undergoing revascularisation for lower limb arterial disease but do not correlate with 30-day clinical outcomes
File(s)
Published version (pre-proof)
Author(s)
Harmer, Georgina
Siracusa, Francesca
Nandhra, Sandip
Shalhoub, Joseph
Type
Journal Article
Abstract
Background
Patient activation refers to the ability of individuals to engage in their healthcare. Studies have shown a positive association between patient activation and improved clinical outcomes in some patient groups.
Objective
This study aims to characterise the level of activation in patients with peripheral arterial disease (PAD) undergoing revascularisation procedures and to determine if patient activation is associated with 30-day clinical outcomes.
Methods
This is a single-centre, prospective, observational study (ethics reference: 23/NS/0078). Patients undergoing planned lower limb revascularisation within a 5-month period were invited to participate and to complete the Patient Activation Measure (PAM) survey prior to their surgery. Responses were scored on a Likert scale and an overall PAM score produced between 1 and 100 (lowest to highest activation). The relationship between baseline characteristics and PAM score was evaluated using linear regression. Spearman’s rank-order correlation and logistic regression was conducted to examine the relationship between PAM scores and 30-day clinical outcomes.
Results
Eighty patients were included in this study. The median age was 71 years (IQR 3 years) and 70% were male. The median PAM score was 53 (IQR 16). Current smokers and patients with type 2 diabetes had significantly lower PAM scores than non-smokers (p<0.05) and non-diabetics (p<0.001). Multivariate regression revealed age and type 2 diabetes were significant predictors of PAM score. There was no association between PAM score and any 30-day clinical outcomes.
Conclusions
Patient activation is low in our sample of PAD patients undergoing revascularisation procedures. This suggests more work is needed to educate and engage patients in self-management of this long-term condition. Patient activation was not correlated with 30-day clinical outcomes, but further research is warranted to determine whether it is related to medium or long-term clinical outcomes.
Patient activation refers to the ability of individuals to engage in their healthcare. Studies have shown a positive association between patient activation and improved clinical outcomes in some patient groups.
Objective
This study aims to characterise the level of activation in patients with peripheral arterial disease (PAD) undergoing revascularisation procedures and to determine if patient activation is associated with 30-day clinical outcomes.
Methods
This is a single-centre, prospective, observational study (ethics reference: 23/NS/0078). Patients undergoing planned lower limb revascularisation within a 5-month period were invited to participate and to complete the Patient Activation Measure (PAM) survey prior to their surgery. Responses were scored on a Likert scale and an overall PAM score produced between 1 and 100 (lowest to highest activation). The relationship between baseline characteristics and PAM score was evaluated using linear regression. Spearman’s rank-order correlation and logistic regression was conducted to examine the relationship between PAM scores and 30-day clinical outcomes.
Results
Eighty patients were included in this study. The median age was 71 years (IQR 3 years) and 70% were male. The median PAM score was 53 (IQR 16). Current smokers and patients with type 2 diabetes had significantly lower PAM scores than non-smokers (p<0.05) and non-diabetics (p<0.001). Multivariate regression revealed age and type 2 diabetes were significant predictors of PAM score. There was no association between PAM score and any 30-day clinical outcomes.
Conclusions
Patient activation is low in our sample of PAD patients undergoing revascularisation procedures. This suggests more work is needed to educate and engage patients in self-management of this long-term condition. Patient activation was not correlated with 30-day clinical outcomes, but further research is warranted to determine whether it is related to medium or long-term clinical outcomes.
Date Issued
2025-07-11
Date Acceptance
2025-07-04
Citation
JVS-Vascular Insights, 2025
ISSN
2949-9127
Publisher
Elsevier
Journal / Book Title
JVS-Vascular Insights
Copyright Statement
© 2025 Society for Vascular Surgery. Published by ELSEVIER INC. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
License URL
Publication Status
Published online
Article Number
100266
Date Publish Online
2025-07-11