CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Peripheral arterial disease (PAD) is a prevalent condition characterized by the narrowing of arteries, resulting in reduced blood flow to the arms or legs (MayoClinic, 2022). It is a circulatory issue that hampers the normal flow of blood through the arteries, leading to diminished blood supply to the extremities. This is often manifested by pain in the thigh or calf while walking or engaging in physical activity (Zemaitis et al., 2022). The primary cause of PAD is the accumulation of fatty plaque, known as atherosclerosis, within the arteries. While PAD can affect any blood vessel, it is more commonly observed in the legs rather than the arms (Centers for Disease Control and Prevention, 2022).
The prevalence of PAD is substantial on a global scale, with approximately 202 million individuals worldwide living with the condition as of 2010. Among them, nearly 70% reside in low-income or middle-income countries. With the global population growth, the number of individuals aged 25 years and older living with PAD reached 236.62 million in 2015 (Song et al., 2019). Both men and women can be affected by PAD, although African Americans face a higher risk compared to other racial groups. Hispanics, on the other hand, may have similar or slightly higher rates of PAD compared to non-Hispanic white individuals (Centers for Disease Control and Prevention, 2022).
While a majority of individuals with PAD do not exhibit symptoms, a considerable number experience intermittent claudication, critical limb ischemia, and in some cases, acute limb ischemia, along with the associated cardiovascular complications. (Song et al., 2019; Bradberry, 2004). This highlights the importance of diagnosing PAD, even in asymptomatic patients, as it serves as an indicator of systemic atherosclerosis and can lead to limb-threatening reduction in blood flow, often requiring immediate surgical intervention.
Patients diagnosed with PAD face a comparable cardiovascular risk to individuals who have experienced a previous heart attack, underscoring the need for proactive management of risk factors to enhance long-term survival. The approach to treating PAD depends on the severity of the disease and the presence of symptoms. There are several treatment options available for PAD, including making lifestyle modifications, reducing cardiovascular risk factors, utilizing medication therapies, considering endovascular interventions, and, in some cases, opting for surgical procedures (Aysert et al., 2018; Yuksel et al., 2018; Tan et al., 2018).
In addition, PAD detrimentally affects the quality of life for patients, leading to limitations in function, decreased mobility, and persistent pain. The condition not only places a substantial economic burden on healthcare systems but also imposes significant indirect costs due to productivity losses. Therefore, it is vital to prioritize the prevention and efficient management of PAD to alleviate its impact on public health. Pharmacists, being readily accessible healthcare providers, have a crucial role to play in the prevention and treatment of PAD.
Pharmacists in the community possess various means to intervene, allowing them not only to ensure that diagnosed patients receive the best possible care but also to advocate for preventive measures, improve medication adherence, and even propose PAD screenings for patients (Colvin, 2019). This study therefore seeks to investigate the roles of pharmacists in the prevention and treatment of peripheral artery disease.
1.2 Statement of the Problem
Patients with PAD face a heightened risk of adverse outcomes, including death, heart attacks, strokes, and limb amputations (Hirsch et al., 2006; Criqui et al., 1997). These vascular events not only lead to a diminished quality of life but also contribute to the high prevalence of depression among these patients.(McDermott et al., 2003; Regensteiner et al., 2008).
Surprisingly, PAD remains a largely underdiagnosed and undertreated condition. Recent epidemiological studies have indicated that when specific at-risk populations are screened, the detection rates of PAD range from 20% to 30%. (Belch et al., 2003). This highlights the necessity for comprehensive and coordinated care to enhance outcomes in PAD management. Pharmacists, being accessible and knowledgeable healthcare professionals, have a significant role to play in bridging these gaps and optimizing the prevention and treatment of PAD.
1.3 Aim of the Study
The aim of this study is to evaluate the roles of pharmacists in the prevention and treatment of PAD.
1.4 Objectives of the Study
The study had the following specific objectives:
- To ascertain the roles of pharmacists in PAD prevention and treatment.
- To analyze the impact of pharmacist interventions on PAD outcomes.
- To provide recommendations for enhancing the involvement of pharmacists in peripheral artery disease prevention and treatment based on the findings.
- What are the roles of pharmacists in PAD prevention and treatment?
- What is the impact of pharmacist interventions on PAD outcomes?
- How can the involvement of pharmacists in peripheral artery disease prevention and treatment be enhanced?
1.5 Research Questions
1.6 Research Hypothesis
H0: Pharmacists do not play significant roles in the prevention and treatment of peripheral artery disease.
Ha: Pharmacists play significant roles in the prevention and treatment of peripheral artery disease.
1.7 Justification of the Study
Peripheral artery disease is a significant health issue affecting a substantial number of individuals worldwide. Pharmacists play a crucial role in the healthcare system, and their involvement in the prevention and treatment of peripheral artery disease has the potential to enhance patient care and outcomes. However, the specific roles and impact of pharmacists in this context are not well understood.
This study will fill this gap by providing a comprehensive evaluation of the roles of pharmacists, identifying challenges, and suggesting strategies for improvement. The findings of this study can inform healthcare policies, practice guidelines, and education programs, ultimately leading to better utilization of pharmacist expertise in peripheral artery disease management.
1.8 Scope of the Study
This study focuses on evaluating the roles of pharmacists specifically in the prevention and treatment of peripheral artery disease.
