Disease understanding in patients with intermittent claudication: A qualitative study

• Nineteen patients suffering from intermittent claudication were interviewed using semistructured interviews.
• The majority of patients were unaware of the underlying atherosclerosis that intermittent claudication indicates.
• The majority of patients attributed their disease to smoking, but not to lack of exercise or imbalanced diet.
• A substantial number of patients attributed their disease to genetics.
• These points indicate a deficit in information transfer; altered counselling strategies could improve lifestyle modification.

The aim of our qualitative study was to investigate the understanding of patients with intermittent claudication (IC) regarding the etiology and atherosclerotic nature of their disease. Patients were recruited from participants of the SUPER study, a randomized trial comparing angioplasty and supervised exercise therapy for alleviation of IC owing to an iliac artery obstruction. Patients were submitted to explorative, semistructured, in-depth interviews that were fully transcribed, coded, and categorized. We interviewed 19 patients. The majority of respondents (79%) recognized smoking as a major risk factor contributing to the etiology of IC. However, nearly one-half (47%) underestimated the effects of unhealthy dietary and exercise patterns. In contrast, a substantial number of respondents (42%) overestimated the contribution of genetics to the etiology of their disease. Most respondents (79%) were unaware of the fact that IC implies systemic atherosclerosis.This study shows that the patients' interpretation of the etiology and nature of IC was mostly incorrect. Therefore, we suggest that health care providers enhance counseling about etiologic factors and the systemic nature of IC to optimize outcomes of lifestyle adjustments.