Abstract：
UNASSIGNED: The global burden of peripheral artery disease (PAD) has been increasing. Guidelines for PAD recommend evidence-based medical therapy (EBMT) to reduce the risks of cardiovascular events and death but the implementation of this is highly variable. This study aimed to understand the current practices regarding EBMT prescription in PAD patients and the key barriers and facilitators for implementing PAD guidelines.
UNASSIGNED: A qualitative study was conducted in the largest tertiary hospital in Singapore from December 2021 to March 2023. The participants included healthcare professionals and in-patient pharmacists involved in the care of PAD patients, as well as patients with PAD who had undergone a lower limb angioplasty revascularisation procedure. Data were collected through in-depth, individual semi-structured interviews conducted face-to-face or remotely by a trained research assistant. Interviews were audio-recorded, transcribed and systematically coded using data management software NVivo 12.0. The Tailored Implementation for Chronic Diseases (TICD) framework was used to guide the interviews and analysis.
UNASSIGNED: Twelve healthcare professionals (4 junior consultants, 7 senior consultants, and 1 senior in-patient pharmacist) and 4 patients were recruited. Nine themes in 7 domains emerged. Only a small proportion of doctors were aware of the relevant guidelines, and the generalisability of guidelines to patients with complicated conditions was the doctors\' main concern. Other barriers included cost, frequent referrals, lack of interprofessional collaboration, not being the patients\' long-term care providers, short consultation time and patients\' limited medication knowledge.
UNASSIGNED: Findings from this study may inform strategies for improving healthcare professionals\' adherence to guidelines and patients\' medication adherence.
UNASSIGNED: A qualitative study was conducted in the largest tertiary hospital in Singapore from December 2021 to March 2023. The participants included healthcare professionals and in-patient pharmacists involved in the care of PAD patients, as well as patients with PAD who had undergone a lower limb angioplasty revascularisation procedure. Data were collected through in-depth, individual semi-structured interviews conducted face-to-face or remotely by a trained research assistant. Interviews were audio-recorded, transcribed and systematically coded using data management software NVivo 12.0. The Tailored Implementation for Chronic Diseases (TICD) framework was used to guide the interviews and analysis.
UNASSIGNED: Twelve healthcare professionals (4 junior consultants, 7 senior consultants, and 1 senior in-patient pharmacist) and 4 patients were recruited. Nine themes in 7 domains emerged. Only a small proportion of doctors were aware of the relevant guidelines, and the generalisability of guidelines to patients with complicated conditions was the doctors\' main concern. Other barriers included cost, frequent referrals, lack of interprofessional collaboration, not being the patients\' long-term care providers, short consultation time and patients\' limited medication knowledge.
UNASSIGNED: Findings from this study may inform strategies for improving healthcare professionals\' adherence to guidelines and patients\' medication adherence.
摘要：
■外周动脉疾病（PAD）的全球负担一直在增加。PAD指南建议使用循证医学治疗（EBMT）来降低心血管事件和死亡的风险，但其实施存在很大差异。本研究旨在了解当前有关PAD患者EBMT处方的实践以及实施PAD指南的主要障碍和促进者。
■于2021年12月至2023年3月在新加坡最大的三级医院进行了定性研究。参与者包括参与PAD患者护理的医疗保健专业人员和住院药剂师，以及接受过下肢血管成形术血运重建手术的PAD患者。通过深入收集数据，由训练有素的研究助理面对面或远程进行的个人半结构化访谈。采访是录音的，使用数据管理软件NVivo12.0进行转录和系统编码。为慢性病量身定制的实施（TICD）框架用于指导访谈和分析。
■12名医疗保健专业人员（4名初级顾问，7名高级顾问，和1名高级住院药剂师）和4名患者被招募。出现了7个领域的9个主题。只有一小部分医生知道相关的指引,指南对复杂疾病患者的普适性是医生们最关心的问题。其他障碍包括成本，频繁的转介,缺乏专业合作，不是病人的长期护理提供者，咨询时间短，患者用药知识有限。
■这项研究的结果可能会为提高医疗保健专业人员“对指南的依从性和患者的用药依从性”的策略提供参考。
■于2021年12月至2023年3月在新加坡最大的三级医院进行了定性研究。参与者包括参与PAD患者护理的医疗保健专业人员和住院药剂师，以及接受过下肢血管成形术血运重建手术的PAD患者。通过深入收集数据，由训练有素的研究助理面对面或远程进行的个人半结构化访谈。采访是录音的，使用数据管理软件NVivo12.0进行转录和系统编码。为慢性病量身定制的实施（TICD）框架用于指导访谈和分析。
■12名医疗保健专业人员（4名初级顾问，7名高级顾问，和1名高级住院药剂师）和4名患者被招募。出现了7个领域的9个主题。只有一小部分医生知道相关的指引,指南对复杂疾病患者的普适性是医生们最关心的问题。其他障碍包括成本，频繁的转介,缺乏专业合作，不是病人的长期护理提供者，咨询时间短，患者用药知识有限。
■这项研究的结果可能会为提高医疗保健专业人员“对指南的依从性和患者的用药依从性”的策略提供参考。
