Understanding adherence to guideline-recommended therapy in patients with peripheral artery disease: A qualitative study

Abstract

Objectives

Adherence to peripheral arterial disease (PAD) treatment remains low, despite its benefit for secondary disease prevention. Currently, there is no qualitative research exploring why this is the case. This study aimed to explore patients’ lived experiences of PAD and its treatment, their motivation to adherence and barriers to non-adherence.

Methods

Semi-structured qualitative interviews were conducted with patients with PAD from diverse backgrounds and varying adherence levels. The Perceptions and Practicalities Approach framed the topic guide and guided analysis. Interviews were recorded, transcribed verbatim, and analysed thematically. A public and patient involvement group supported the pilot testing of the topic guide and the data analysis.

Results

Twelve participants (eight men and four women, with an age range between 56 and 78) participated in the study. Six themes were identified: (1) Treatment necessity and effectiveness, (2) Information, (3) Mind-over-matter, (4) Concerns, (5) Physical environment, (6) Social and healthcare professional interactions. Patients perceiving their treatment to be effective were more likely to be adherent. However, some patients did not see themselves as being on treatment as they were not getting better. Participants expressed a lack of support and a need for detailed information and individualised care.

Conclusion

Our findings illustrate that patients’ perceptions of treatment effectiveness seem to influence their adherence. To enhance adherence, future research should focus on improving treatment understanding, optimising patient experiences, addressing claudication pain management, and supporting patients to be more motivated to make changes.