Peripheral arterial disease (PAD) occurs when there is a narrowing or occlusion of the peripheral arteries, resulting in reduced blood flow to the leg (National Institute for Health and Care Excellence (NICE), 2015). This can lead to limb ischaemia and thrombosis. Patients with PAD have a reduced quality of life and are at risk of lower limb amputation and even death. This article addresses the need for early diagnosis of PAD to reduce the burden of the condition to patients and the NHS, and to try and reduce the number of lower limb amputations that occur in the UK every day. Promoting healthy arteries will raise awareness of the risk factors associated with PAD and encourage the population in the risk categories to be proactive in receiving ankle-brachial pressure index (ABPI) assessment. Healthcare professionals with improved knowledge of PAD will be better able to identify patients in the early stages of the disease and to advise them about lifestyle changes to improve their prognosis.
Compression therapy is a key component of venous leg ulcer management. Best practice guidelines recommend that an ankle brachial pressure index (ABPI) is determined before applying full compression to establish if peripheral arterial disease (PAD) is present. However, a recent study by Guest et al (2015) highlighted that 84% of patients with a wound to the foot or leg have no recorded ABPI. The reasons for this are thought to be insufficent time to carry out the assessment (Chamanga et al, 2014), and lack of competency (Worboys, 2006).
Lower limb ulceration is a common, debilitating and costly condition that accounts for over one third of chronic wounds in the UK. The most common underlying causes of leg and foot ulceration are venous insufficiency, arterial insufficiency, lymphoedema and diabetic neuropathy. More than half of leg ulcers do not have a recorded diagnosis and are unlikely to receive appropriate care. Poor care can cost up to ten times as much as appropriate care. The Legs Matter campaign aims to change this situation through a public health campaign supported by a website: http://legsmatter.org. The website provides clearly written, easily accessible information for patients, the public and generalist healthcare professionals along with signposts to reputable sources of information. In this way, the campaign aims to raise awareness that leg and foot conditions can be improved with the right care.
Sharon Goodall & Mr Haytham Al-Khaffaf describe a study which evaluated primary care assessment of risk factors in patients with peripheral vascular disease.
Sharon Goodall RN, Dip (HE), BSc (Hons), PG Cert (Research) is a Vascular Research Nurse. Mr Haytham Al-Khaffaf MD, FRCS is a Consultant Vascular Surgeon, Burnley Healthcare NHS Trust.
Article accepted for publication September 2001.
