Abstract
OBJECTIVE: Lower extremity peripheral artery disease (PAD) is a highly prevalent chronic condition that can lead to decreased quality of life, poor physical functioning, and increased risk of cardiovascular death. PAD knowledge is low among both the general public and patients. The objectives of this study were to understand patient perspectives on PAD education and obtain their feedback on an online PAD video education tool. METHODS: In this single-center multi-method study, patients with PAD were recruited from an outpatient vascular surgery clinic and inpatient vascular surgery service at an academic hospital. Participants completed a 56-item survey assessing demographics, socioeconomic status, and functional health literacy (measured by the Short Test of Functional Health Literacy). Medical history was obtained from the electronic health record. Participants then watched a 20-minute professionally produced video on the definition, presentation, associated risks, and treatment of PAD. This was followed within 7 days by a semi-structured interview. Interviews were conducted in person or over the phone and included questions on prior use of educational tools, understanding of PAD risk-modifying behaviors, and feedback on the video. Interviews were audio recorded and transcribed. A codebook was deductively and inductively developed, and thematic analysis was conducted using the constant comparative approach to identify overarching themes. RESULTS: There were 20 participants (average age, 65.4 ± 12.2 years; 30.0% female; 55.0% Black; 55.0% adequate functional health literacy). We identified three themes regarding current PAD education practices and video feedback. First, current PAD education is primarily obtained from clinicians and the internet. Second, although participants generally liked the video, short-term recall of video content was poor, and there were persistent deficits in PAD knowledge. Third, participants prioritized interpersonal discussions with clinicians for PAD education. CONCLUSIONS: Patients have knowledge deficits about PAD that persist after the video. They most commonly look to their clinicians and the internet for PAD education. Participants accepted the online PAD video education tool but value interactive discussions, indicating that the video may best serve as an adjunctive tool for PAD education. Future research should focus on identifying patients who would most benefit from this tool and the development of other strategies to optimize patient education about PAD.