Enhancing care for patients with critical limb ischaemia
Research type
Research Study
Full title
Can a dedicated chronic limb-threatening ischaemia (CLTI) clinic improve patient self-reported quality of life?
IRAS ID
292300
Contact name
Tom Wallace
Contact email
Sponsor organisation
Leeds Teaching Hospitals NHS Trust
Clinicaltrials.gov Identifier
VS22/151953, VS22/151953
Duration of Study in the UK
1 years, 0 months, 2 days
Research summary
Chronic limb-threatening ischaemia(CLTI) is the most severe manifestation of peripheral arterial disease (PAD) and affects 1% of the population and its prevalence is expected to rise. The natural history of CLTI carries a grave prognosis; 22% of CLTI patients will lose their leg and another 22% will die within 12 months. 50% of patients who have a major amputation will be dead within 2 years.
The CLTI clinic facilitates assessment, investigation and revascularisation procedures to save the affected limb(s). Patients with advanced age (over 65), concomitant health conditions or frailty (a Rockwood Frailty Score over 5) are referred from the CLTI clinic to a physician-led specialist medical optimisation service (POPS – Perioperative Care for Older People undergoing Surgery). Both of the CLTI clinic and POPS services have been operational since 2021. The POPS clinic exists separately, sees all manner of vascular patients but a large proportion of these come from CLTI clinic.
These services exist to improve patient outcomes; specialist CLTI clinics can improve limb salvage rates and POPS is associated with fewer post-operative complications, a shorter length of stay, and a better functional status on discharge.
Both these initiatives were designed with patients in mind, however we want to undertake a qualitative analysis to establish the opinions of the patients, their carers and relatives who use them, and if there are improvements that could be made. This will be both in the forms of measuring the self-reported quality of life scales (using Euro-QoL 5D) before and after CLTI clinic assessment and management, and also structured feedback surveys to establish patient / relative / carer opinions of the services. We think this evaluation is vital as the service has been implemented to benefit patients, their carers and relatives, but we don’t know how the users the service actually feel about it.
REC name
Social Care REC
REC reference
22/IEC08/0034
Date of REC Opinion
9 Nov 2022
REC opinion
Favourable Opinion