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PrEPAID- Pain Management and Patient Education for Physical Activity in Intermittent Claudication

July 2017 - July 2019

Live project

Peripheral Arterial Disease (PAD) is a common vascular condition which affects 2.7 million people in the UK and causes narrowing of the arteries. The most common symptom that patients with PAD experience is Intermittent Claudication (IC), pain in the lower limb(s) on exertion, which is relieved by rest. IC reduces patients’ quality of life (QoL) by limiting their ability to walk and engage in daily activities. Also, due to the diffuse nature of atherosclerosis that they suffer, people with IC have 3-4 times increased mortality compared to those of similar age without the condition.

Regular exercise and physical activity (PA) are central to the management of PAD and help to improve walking distances and reduce the risks associated with PAD such as heart attack and stroke. However, exercise and PA in this population is often limited due to pain. We have shown that Transcutaneous Electrical Nerve Stimulation (TENS) can help to reduce pain and increase walking distance in patients with PAD. We have also shown that educating patients about their condition and helping them to set goals has the potential to increase PA, and quality of life. The PrEPAID trial is collaborative investigation involving researchers from University of Glasgow (Prof Julie Brittenden), NHS GG&C (Mr Wesley Stuart) and Northumbria University (Dr Garry Tew) and will examine the feasibility of designing a definitive trial that investigates whether TENS can improve the physical activity of patients with PAD when delivered alone and/or alongside a patient education programme.

Expected Impact
This feasibility study will provide information to inform a future definitive trial. Data will be collected about the acceptability and the potential for effectiveness of the proposed intervention, achievable recruitment and retention rates, and outcome distribution to inform sample size estimation. If feasibility (including evidence of potential efficacy) is demonstrated, we intend to seek funding to conduct a future definitive RCT. We expect a future definitive RCT to strengthen evidence based practice regarding the cost- and clinical-effectiveness of using patient centred education and pain management using TENS as alternative or adjunct therapies to SEPs.

Staff Involved