Abstract
Background
Peripheral Arterial Disease (PAD) is an increasingly prevalent long-term illness globally. The Ankle Brachial Pressure Index (ABPI) is a well-established, simple, relatively quick, inexpensive and non-invasive assessment useful in diagnosing and quantifying PAD with varying symptomology. Though literature has documented many theoretical benefits associated with its use, ABPIs are still underutilised in general practice.
Aims
The study aimed to investigate the usefulness of ABPIs in general practice.
Methods
This study used quantitative analysis of routine electronic practice data from Mosgiel Health Centre between 2006-2015. The study also analysed thirteen one-to-one interviews with healthcare professionals regarding views on the usefulness of the ABPI in general practice.
Results
The quantitative arm showed that of 379 patients having ABPI tests over ten years, half were completed to investigate venous compression therapy eligibility and half investigated arterial-related symptoms. Of all patients who had ABPIs, 26% were referred to the vascular department. ABPIs helped to prevent inappropriate referrals in over 70% of cases. Patients living in more socially deprived areas were over-represented in the ABPI group.
The qualitative arm showed that GPs are aware that ABPIs are beneficial to patients: through ruling in or out PAD to aid management, to aid triage for hospital-based systems and to implement immediate therapy in the community. Practical barriers were discussed, including cost, time and low patient need.
Conclusion
There are marked benefits associated with ABPI use in general practice. However, practical barriers need to be overcome before ABPIs are considered as a viable investigation for some GPs.