PAD: Why Are We Struggling to Stick to the Plan?

Peripheral artery disease (PAD) is a serious condition that affects the blood vessels, often leading to poor blood flow in the legs. Doctors have clear guidelines for treating PAD, including medicines like antiplatelet, lipid-lowering, and antihypertensive drugs, as well as lifestyle changes like quitting smoking, eating well, managing weight, and staying active. However, many patients find it hard to stick to these recommendations. This is where multicomponent interventions come in. These are programs that combine different strategies to help patients follow their treatment plans. A recent review looked at 15 studies involving 2, 462 patients, mostly men. These studies tested various multicomponent interventions to see if they could improve adherence to PAD treatments. The findings were mixed. Only two of the studies covered all the recommended treatments. Most interventions included structured exercise programs and educational sessions. These were usually led by teams of healthcare professionals in hospitals and lasted about three months. The review used a specific checklist and behavioral change techniques to evaluate these interventions. The review found that most interventions focused on giving patients instructions on how to perform certain behaviors, rather than using a variety of behavioral change techniques. Only one study used behavioral theory in its design. This means that many interventions might not be addressing the root causes of why patients struggle to adhere to their treatment plans. The review also highlighted that there is a lack of research on how these interventions affect adherence. This makes it hard to figure out what works best. Most interventions did not use behavioral science approaches, which could help tailor treatments to individual patient needs. Future interventions should consider these factors to better support patients with PAD.