p eripheral a rterial d isease
DESCRIPTION
P eripheral A rterial D isease. Class 5, 1 st year 2009/2010 Adviser: Sérgio Sampaio. Patients’ awareness of smoking as a risk factor. Narrowing and hardening of arteries. INTRODUCTION: BACKGROUND. Decreased blood flow. PAD. - PowerPoint PPT PresentationTRANSCRIPT
PeripheralArterial
Disease
Patients’ awareness of smoking as a risk factor
Class 5, 1st year2009/2010
Adviser: Sérgio Sampaio
McDermott MM. Cleve Clin J Med. 2006.Remes L, et al. 2008.Gutacker N, et al. 2009.Zanati SG, et al. Clinics. 2009.
INTRODUCTION: BACKGROUND
Narrowing and hardening of arteries
Decreased blood flow
PAD
Difficulty in walking, rest pain, ulceration, lower extremity amputation,
death.
Risk Factors
Hypertension Hypercholesterolemia
Diabetes Smoking
Selvin E. et al. Circulation. 2004.
Criqui MH. Vasc Med. 2001.
Awareness of smoking as a risk factor
Don't know44%
Know56%
Hirsch AT et al. Circulation. 2007.
JustificationWe decided to evaluate the awareness of
smoking as a risk factor because:
People, most of the times, cannot control the expression of diabetes, but it is their choice to smoke or not to;
There is a low community consciousness of this risk factor.
Justification
It will be important to know the awareness of the
Portuguese PAD patients to this modifying risk
factor, because that way it will be easier to define
strategies to improve the communication and to try
to make people change their smoking habits.
Research Question
How aware are patients with PAD regarding smoking as a major risk factor?
Aims1. Quantify how frequently patients with PAD know
about smoking as a cause and a prognostic of their condition.
2. Determine when and by whom were they warned about this fact.
3. Find out whether people in this state have changed or not their smoking habits due to the provided information.
• (If they have) Find out if the severity of the disease altered.
Participants and MethodsOur target population are
Portuguese patients suffering from PAD who are admitted in a hospital.
Our inclusion criterion is the patients with PAD being admitted in the Vascular Surgery Department of Hospital de S. João.
Our exclusion criteria are:
Patients unable to consciously communicate;
Patients who do not agree to get involved in this study.
Participants and Methods
Study designAnalytic retrospective cohort:
patients who were informed of tobacco as a risk factor with patients who were not (cohort)
events that happened in the past (retrospective):try to establish the relations among them (analytic)
Present
Past FutureInformed Not Informed
Data collecting methods
Questionnaires were done to patients suffering from PAD, who were admitted in the Vascular Surgery Department of Hospital de São João.
Sample
68%(28)
32%(13)
PatientsIncluded Excluded
Exclusion criterion:Patients unable
to consciously communicate.
Variables description
Personal data of PAD patientsDiabetes;Hypertension;Hypercholesterolemia;State of the disease at the time of the diagnosis,
according to Lerishe-Fontaine classification; Current state of the disease;Date of PAD diagnosis;Smoking habits;
Variables description
PAD risk factors awarenessAwareness of:
Diabetes;Hypercholesterolemia;Hypertension;Smoking;
Knowledge sources;• If the information was given by a doctor, another variable we
decided to put was the specialty of the doctor . Time of risk factors awareness.
Variables description
Behaviour changes after awareness of PAD risk factors:
Change of smoking habits;Way of change;Number of attempts, if the interviewed patient
tried to quit smoking without success.
Statistical analysis/Expected results
Scholar degree and the awareness of the risk factors;
Time of risk factors awareness and date of PAD
diagnosis;
Change of smoking habits (type of change) and state
of the disease after that behaviour change (evolution
of the disease).
Sample description
Female Male
21.40%
78.60%
Gender
Sample description
Mean=64,71
Ensino
prim
ário
2.º ci
clo
3.º ci
clo
Ensino
secu
ndári
o
Ensino
supe
rior
76.9%
3.8%15.4%
3.8% 0.0%
Escolaridade
Sample description
Sample description
Non smoker43%
Smoker11%
Former smoker
46%
Smoking habits
Results
Yes75%
No21%
Don't know4%
Awareness of smoking as a risk factor
Know44%Don't
know56%
Hirsch AT et al. Circulation. 2007.
Results
1-4 years (20) 5-6 years (1) 7-9 years (4) 10-12 years (1)
50%
100%
75%
100%
Awareness of diabetes
Results
1-4 years 5-6 years 7-9 years 10-12 years
50%
100%
75%
100%
Awareness of hypertension
Results
1-4 years 5-6 years 7-9 years 10-12 years
45%
100%
50%
100%
Awareness of hypercholesterolemia
Results
1-4 years 5-6 years 7-9 years 10-12 years
85%100%
50%
0%
Awareness of smoking
Results
54%31%
15%
Time of risk factors awareness
Before PAD diagnosis
At the moment of PAD diagnosis
After PAD diagnosis
Results
15%(2)
62%(8)
23%(3)
State of the disease after smoking habits change
Did not evolute
Got better
Got worse
Results
12%4%
8%
77%
Knowledge sources
TVNewspapersFriends/familyDoctor
ObservationsAfter 20 days, we have a small sample (N=28).
Therefore, the results we achieved were not statiscally significant and there is no variability among some data.
We were not able to relate some important variables, such as Change of smoking habits (type of change) and State of the disease after that behaviour change (evolution of the disease).