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Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study

BACKGROUND: Peripheral artery disease (PAD) patients have high morbidity and mortality rates, demonstrating a need for improved treatment strategies. While underuse and undertreatment have been reported, there is no clear picture of patterns in population-level disease prevalence, prescription of gu...

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Autores principales: Rammos, Christos, Steinmetz, Martin, Lortz, Julia, Mahabadi, Amir A., Petrikhovich, Olga, Kirsch, Kristina, Hering, Ramona, Schulz, Mandy, Rassaf, Tienush
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454876/
https://www.ncbi.nlm.nih.gov/pubmed/34557822
http://dx.doi.org/10.1016/j.lanepe.2021.100113
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author Rammos, Christos
Steinmetz, Martin
Lortz, Julia
Mahabadi, Amir A.
Petrikhovich, Olga
Kirsch, Kristina
Hering, Ramona
Schulz, Mandy
Rassaf, Tienush
author_facet Rammos, Christos
Steinmetz, Martin
Lortz, Julia
Mahabadi, Amir A.
Petrikhovich, Olga
Kirsch, Kristina
Hering, Ramona
Schulz, Mandy
Rassaf, Tienush
author_sort Rammos, Christos
collection PubMed
description BACKGROUND: Peripheral artery disease (PAD) patients have high morbidity and mortality rates, demonstrating a need for improved treatment strategies. While underuse and undertreatment have been reported, there is no clear picture of patterns in population-level disease prevalence, prescription of guideline-recommended pharmacotherapy, or frequency of contact with dedicated specialists. We present population-level data on changes in prevalence, care and treatment of PAD from 2009 to 2018 in Germany. METHODS: We analyzed the ambulatory claims data for all statutorily insured patients comprising 70.1 million patients each year and 87% of the German population. Prevalence was assessed by documentation of PAD and stratified by age and sex within the 10-year study timeframe. In addition, current ambulatory care, stratified by vascular specialists (vascular surgeons or angiologists), internists, cardiologists and primary care physicians, were examined. FINDINGS: Prevalence increased from 1·85% in 2009 to 3·14% in 2018, affecting 2·3 million patients in 2018 and more males (55%) than females (45%). A low level of visits to vascular specialists, with 11·1% receiving care from vascular surgeons and 8·1% from angiologists, was shown. Moreover, analysis of guideline-recommended prescriptions revealed increasing, but still insufficient, prescription frequencies among PAD patients between 2009 and 2016, from 42·6% to 56% for statins and from 40·2% to 48·0% for antiplatelets. INTERPRETATION: Our results show that the prevalence of PAD in Germany, as assessed by outpatient PAD documentation, is increasing and PAD patients are underutilizing specialized vascular care; moreover, the prescription frequency of guideline-recommended therapies remains low. There is a clear need to improve the referral and treatment algorithms in the high-risk PAD population. FUNDING: None.
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spelling pubmed-84548762021-09-22 Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study Rammos, Christos Steinmetz, Martin Lortz, Julia Mahabadi, Amir A. Petrikhovich, Olga Kirsch, Kristina Hering, Ramona Schulz, Mandy Rassaf, Tienush Lancet Reg Health Eur Research Paper BACKGROUND: Peripheral artery disease (PAD) patients have high morbidity and mortality rates, demonstrating a need for improved treatment strategies. While underuse and undertreatment have been reported, there is no clear picture of patterns in population-level disease prevalence, prescription of guideline-recommended pharmacotherapy, or frequency of contact with dedicated specialists. We present population-level data on changes in prevalence, care and treatment of PAD from 2009 to 2018 in Germany. METHODS: We analyzed the ambulatory claims data for all statutorily insured patients comprising 70.1 million patients each year and 87% of the German population. Prevalence was assessed by documentation of PAD and stratified by age and sex within the 10-year study timeframe. In addition, current ambulatory care, stratified by vascular specialists (vascular surgeons or angiologists), internists, cardiologists and primary care physicians, were examined. FINDINGS: Prevalence increased from 1·85% in 2009 to 3·14% in 2018, affecting 2·3 million patients in 2018 and more males (55%) than females (45%). A low level of visits to vascular specialists, with 11·1% receiving care from vascular surgeons and 8·1% from angiologists, was shown. Moreover, analysis of guideline-recommended prescriptions revealed increasing, but still insufficient, prescription frequencies among PAD patients between 2009 and 2016, from 42·6% to 56% for statins and from 40·2% to 48·0% for antiplatelets. INTERPRETATION: Our results show that the prevalence of PAD in Germany, as assessed by outpatient PAD documentation, is increasing and PAD patients are underutilizing specialized vascular care; moreover, the prescription frequency of guideline-recommended therapies remains low. There is a clear need to improve the referral and treatment algorithms in the high-risk PAD population. FUNDING: None. Elsevier 2021-05-03 /pmc/articles/PMC8454876/ /pubmed/34557822 http://dx.doi.org/10.1016/j.lanepe.2021.100113 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Rammos, Christos
Steinmetz, Martin
Lortz, Julia
Mahabadi, Amir A.
Petrikhovich, Olga
Kirsch, Kristina
Hering, Ramona
Schulz, Mandy
Rassaf, Tienush
Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study
title Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study
title_full Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study
title_fullStr Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study
title_full_unstemmed Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study
title_short Peripheral artery disease in Germany (2009–2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – A population-based study
title_sort peripheral artery disease in germany (2009–2018): prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy – a population-based study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454876/
https://www.ncbi.nlm.nih.gov/pubmed/34557822
http://dx.doi.org/10.1016/j.lanepe.2021.100113
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