Peripheral artery disease (PAD) is a common condition that affects more than 12 million people in the U.S. However, it’s more prevalent in patients who are over the age of 50, and the risk increases with age. Its main target is a person’s extremities. In fact, it typically affects the legs more than the arms, and it affects both men and women.
Risk factors for PAD include:
- Smoking
- Hypertension
- Diabetes
- Atherosclerosis
- Hypercholesterolemia
- More advanced age
- African American race
When fatty plaque deposits build up inside the arteries that carry the oxygenated blood to the extremities, it causes stenosis of the arteries. This reduces blood flow and results in pain, numbness, cramping, and difficulty healing. It can even lead to amputation, heart attack, or stroke.
Patients with PAD can help reduce the symptoms and prevent further progression of the disease through claudication medications and lifestyle changes, such as exercise and a healthy diet. These alone are enough to slow down the progression of the disease or even reverse the symptoms.
As their pharmacist, there are things you can do to help your PAD patients manage the disease. Suggest the following tips to help stop their symptoms from getting worse:
Don’t smoke or use tobacco
A major, preventable risk factor for PAD is tobacco smoke. Smoking damages the arteries and increases the risk of peripheral artery disease. Most people struggle with smoking cessation, but you can recommend effective tools that can help them quit, such as nicotine replacement products, behavior modification techniques, and medications that can curb cravings.
Exercise regularly
An effective treatment for PAD symptoms is physical activity because exercise helps improve blood flow to the arms and legs. Healthcare professionals typically recommend supervised exercise therapy for people with PAD. A program of exercise and education can help increase the distance they can walk without pain.
Eat healthy foods
Remind them to select plenty of fruits, vegetables, and whole grains. Limit fat to 30 percent of your total daily calories. Saturated fat should account for no more than 7 percent of your total calories. Avoid trans fats, including products made with partially hydrogenated and hydrogenated vegetable oils.
Read medication labels
Advise against products that contain pseudoephedrine. These medications are often used to treat a stuffy nose due to allergies or colds. However, pseudoephedrine tightens blood vessels and may increase PAD symptoms.
Pay attention to leg position
Remind patients to sleep with the head of their bed raised a few inches. That way their legs are below the level of their heart and can reduce pain. Sometimes hanging their legs over the edge of the bed or walking can also temporarily reduce leg pain.
The feet are another important part of the body to pay close attention to. PAD can make it a lot harder for cuts and sores on the lower legs and feet to heal, especially if they have both PAD and diabetes.
If you haven’t already, counsel your PAD and diabetes patients on how to keep their feet healthy. Make printouts of the information below and give them to your patients to take home as reminders.
Proper Foot Care
- Wash your feet every day and dry them completely.
- Use a good moisturizer on your feet to prevent cracks that can lead to infection. Don’t moisturize between the toes because this can cause fungus to grow.
- Wear thick, dry socks and shoes that fit well.
- Treat any fungal infections of the feet quickly, such as athlete’s foot.
- Be careful when trimming your toenails.
- Check your feet daily for cuts, sores, or other injuries. If you find any, visit a healthcare professional.
- Go to a podiatrist if you have bunions, corns, or calluses.
You can also help your PAD patients with:
Medication Management
- Prescriptions: You can dispense medications prescribed to manage PAD, such as antiplatelet agents (e.g. aspirin, clopidogrel) to reduce blood clot risk, and medications to manage associated conditions like high blood pressure and cholesterol.
- Adherence Counseling: Make sure your patients have guidance and education on how to take their medications safely and correctly. Ensure that your patients understand their medication regimen along with the importance of adherence. This is vital for managing PAD and preventing complications.
Counseling and Education
- Disease Management: You can educate your patients about PAD, including symptoms, progression, and the importance of lifestyle changes, such as smoking cessation and exercise.
- Medication Information: Inform patients on how medications work, the potential side effects, and interactions with other drugs or foods.
Monitoring and Support
- Blood Pressure and Blood Glucose Monitoring: Remind patients that regular monitoring of their blood pressure and glucose levels can help in managing comorbid conditions that often accompany PAD.
Referral and Coordination
- Healthcare Team: Work with primary care physicians, cardiologists, dietitians, and other health providers to ensure comprehensive care.
- Specialist Referrals: Help your patients find specialists if needed, such as vascular surgeons or dieticians.
Preventive Care
- Vaccinations: Encourage your patients to get their vaccines, such as the flu shot and COVID-19.
Health Screenings
- Risk Assessment: Monitor and assess risk factors like cholesterol levels and blood glucose and provide recommendations for managing these conditions.
Because PAD is a painful disease and can disrupt the quality of life, you can also monitor your patients for depression and anxiety. When appropriate, recommend psychotherapy or medications (or both) to help them manage their symptoms.
More articles from the September 2024 issue:
- PBMs Exposed
- Cybersecurity in Your Pharmacy
- Diagnosing Alzheimer’s Disease
- Patient Medication Reviews
- A New Direction for Continuous Glucose Monitors
- The Prevalence of Osteoarthritis
- Vaccine Overview 2024-25
- Peripheral Artery Disease
A Member-Owned Company Serving Independent Pharmacies
PBA Health is dedicated to helping independent pharmacies reach their full potential on the buy-side of their business. Founded and run by pharmacists, PBA Health serves independent pharmacies with group purchasing services, wholesaler contract negotiations, proprietary purchasing tools, and more.
An HDA member, PBA Health operates its own NABP-accredited warehouse with more than 6,000 SKUs, including brands, generics, narcotics CII-CV, cold-storage products, and over-the-counter (OTC) products — offering the lowest prices in the secondary market.
