Abstract
Introduction: Intermittent claudication (1C) is the most common classic symptom of peripheral arterial disease (PAD). 1C places significant limitations to physical function in individuals with PAD leading to poor disease outcomes. A large body of research now highlights the important of a patient-centred approach in the management of PAD and 1C.Purpose: To develop a patient centred low cost intervention to increase free-living physical activity (PA) in individuals with PAD and 1C. This thesis focused on three stages of the intervention development: a) Identifying the evidence base, and useful components; b) Intervention development; and c) Designing the protocol for a feasibility evaluation.
Method: The intervention development was informed by the Medical Research Council (MRC) framework for complex intervention development, and the thesis was implemented in three phases. First, a series of systematic reviews identified the evidence base and useful components for the intervention. In the second phase, an intervention was developed using the evidence base and identified components. The last phase designed a protocol to test the feasibility of the intervention.
Results: Supervised exercise is an underutilised modality for patients with 1C despite health professionals recognition of it benefits. Some experiences might be unique to a particular stage and/or management modality (e.g. rationale of walking in spite of pain in a supervised exercise programme) throughout journey with PAD. Multidimensional factors influence walking exercise in patients with 1C. Pain management and patient education were identified as key elements of an intervention to increase PA in patients with 1C. An intervention comprising of a Pain management and Patient Education for PA improvement in individuals with Intermittent ClauDication (PrEPAID) was developed. The design of the protocol for feasibility testing of PrEPAID was executed.
Conclusion: The MRC framework was used and to develop PrEPAID. This intervention, if tested and found feasible and beneficial, may potentially serve as an adjunct to enhance the uptake of exercise recommendations. Findings and lessons learned from the planned feasibility trials will inform further refining, planning, and design of a full-scale trial.
| Date of Award | 2018 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Chris Seenan (Supervisor) & Philippa Dall (Supervisor) |