Multicomponent interventions designed to support adherence to guideline-recommended therapy in patients with peripheral artery disease: a scoping review
Author(s)
Type
Journal Article
Abstract
Adherence to guideline-recommended therapies for peripheral artery disease (PAD), including pharmacotherapy (antiplatelet, lipid-lowering, and antihypertensive agents) and lifestyle modifications (smoking cessation, diet, weight management, and physical activity) remains low. Though single-component interventions targeting smoking cessation, exercise, or medication adherence show some efficacy, comprehensive multicomponent interventions are vital for addressing the complexity of PAD management. This review systematically synthesized multicomponent interventions for patients with PAD. A systematic search was conducted in Embase, MEDLINE, Cochrane Library, APA PsycINFO, CINAHL, Web of Science Core Collection, ProQuest, and Google Scholar to identify primary research describing multicomponent interventions supporting PAD treatment adherence, published between 2007 and 2024. A narrative synthesis was reported using the Template for Intervention Description and Replication (TIDieR) checklist and the behavioral change techniques (BCT) taxonomy. Out of 15 studies (2462 patients, 60.4% men) included in this review, only two addressed all guideline-recommended treatment aspects. Key intervention components included structured exercise (12/15) and education programs (10/15). Most interventions were delivered by multidisciplinary teams in hospital settings over 3 months. Only one study employed behavioral theory in its development, and most interventions (13/15) focused on the BCT ‘instructions on how to perform a behavior’ rather than diverse BCTs. No interventions significantly increased adherence to all PAD therapies. Few studies measured the intervention’s impact on adherence, making it difficult to determine effective intervention characteristics. Most interventions lacked behavioral science approaches and were not designed to address specific adherence determinants. Future interventions should incorporate these elements to effectively address patients’ needs. Open Science Framework Registry ID: osf.io/7xqzj
Date Issued
2025-06-01
Date Acceptance
2025-03-01
Citation
Vascular Medicine, 2025, 30 (3), pp.343-352
ISSN
1358-863X
Publisher
SAGE Publications
Start Page
343
End Page
352
Journal / Book Title
Vascular Medicine
Volume
30
Issue
3
Copyright Statement
© The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40079704
Subjects
behavior change techniques
guideline-directed medical therapy
medication adherence
peripheral artery disease (PAD)
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2025-03-13