Abstract 260: Provider Perspectives On Peripheral Artery Disease: Uncovering Practice Patterns That May Contribute To Health Disparities

Background: PAD is often undiagnosed and undertreated. Black American and Hispanic patients experience greater disease severity and worse outcomes compared to white patients. Applying the Kilbourne et al.’s comprehensive framework which identifies multilevel determinants of health disparities, we sought to understand why disparities exist by identifying provider factors that explain gaps in health and health care.

Methods: Semi-structured in-depth interviews were conducted with 19 providers across diverse specialties from two clinical sites. Interviews occurred from November 2021 to February 2022. Domains of interest were provider factors that contribute to delays in diagnosis, treatment, and management of PAD, as well as how providers communicate with patients about PAD. Interviews were professionally transcribed and analyzed using a qualitative content analysis methodology.

Findings: Specialists noted that the diagnosis of PAD may be delayed due to the lack of consistent early detection of risk factors and screening. PCPs felt that diagnosis of PAD is difficult due to patient under recognition of symptoms, symptoms mimicking other diseases, and asymptomatic patients. Both specialists and PCPs highlighted delayed PAD diagnosis due to a lack of clear guidelines for screening. Broader institutional constraints on screening for and diagnosing PAD related to time, resources, and logistics for both specialists and PCPs. There was general agreement that disease awareness and knowledge was lacking by both providers and patients, and may contribute to gaps in screening, treatment, and management of disease across the health care system. Some providers noted differences across populations in access to care and interventions, which may contribute to health disparities around PAD. Implications for Cardiovascular and Health Disparities Research: Overall, there is a clear sense among providers representing multiple disciplines that diagnosis of PAD is challenging. To address these challenges, more work needs to be to develop clinic team approaches to screen for PAD symptoms in at-risk patients. To close the gap in health disparities, patient perspectives should also be sought to better understand specific needs among different populations.