Open AccessEvidence-based medical treatment of peripheral arterial disease: A rapid review
Author(s) -
Sze Ling Chan,
Revvand Rajesh,
Tjun Yip Tang
Publication year - 2021
Publication title -
annals, academy of medicine, singapore/annals of the academy of medicine, singapore
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 60
ISSN - 0304-4602
DOI - 10.47102/annals-acadmedsg.2020649
Subject(s) - medicine , observational study , diabetes mellitus , medline , population , adverse effect , cohort study , arterial disease , randomized controlled trial , intensive care medicine , physical therapy , vascular disease , environmental health , political science , law , endocrinology
: Peripheral arterial disease (PAD) treatment guidelines recommend the use of statinsand antiplatelets in all PAD patients to reduce adverse cardiovascular and limb-related outcomes. Inaddition, hypertension and diabetes should be treated to reach recommended targets. The aim of thisrapid review was to evaluate the level of adherence to evidence-based medical therapy (EBMT)recommended by PAD treatment guidelines in the real-world setting.Methods: We searched PubMed and Embase using keywords, MeSH and Emtree terms related to thepopulation, exposure and outcomes from their inception to 22 September 2020. We included randomisedcontrolled trials, non-randomised studies, and observational studies reporting adherence to at least 1 ofthese 4 drug classes: (1) statins, (2) antiplatelets, (3) antihypertensives and (4) antidiabetic drugs.Non-English articles, abstracts, dissertations, animal studies and case reports or series were excluded.A narrative summary of the results was performed.Results: A total of 42 articles were included in the review. The adherence to lipid-lowering drugs/statinsranged from 23.5 to 92.0% and antiplatelets from 27.5 to 96.3%. Only 7 and 5 studies reported use of“any anti-hypertensive” and “any anti-diabetic” medications, respectively, and the proportion of the cohorttreated were generally close to the proportion with hypertension and/or diabetes. Adherence in studiespublished in 2016–2020 ranged from 52.4–89.6% for lipid-lowering drugs and 66.2–96.3% for antiplatelets.Conclusion: EBMT adherence in PAD patients was highly variable and a substantial proportion inmany settings were undertreated. There was also a notable lack of studies in Asian populations.Keywords: Evidence-practice gap, medication adherence, pharmacoepidemiology