Grant: Doctoral: Vanier Canada Graduate Scholarships

Supervisor: Dr. Derek Roberts, University of Ottawa. Background: About 10% of older Canadians have hardening of the leg arteries. People with leg artery disease have a high risk of heart attack, stroke, amputation, and death. Clinical practice guidelines recommend providing certain blood thinner, cholesterol, and blood pressure-lowering medications to people with leg artery disease. This is because these medications reduce the risk of the above-mentioned bad outcomes. However, studies conducted outside of Canada report that these medications are often underprescribed to people with leg artery disease. Underprescription of these medications represents an important gap between what we know, what we should be doing and what we are actually doing in practice that could be narrowed to improve outcomes. Methods: The research proposed in this application has several aims including: 1) To conduct a systematic review of the literature to identify and summarize existing studies examining interventions to improve prescription of guideline-recommended medications to people with leg artery disease. 2) To estimate how often guideline-recommended medications are not prescribed to Canadians with leg artery disease and which Canadians are at highest risk for not being prescribed them. We will also determine the health and health system consequences of not providing these medications to people with leg artery disease. 3) To understand the patient and provider (i.e., doctor/nurse) factors that might influence whether patients with leg artery disease are prescribed guideline-recommended medications in Canada. Discussion: We plan to use the above research findings to design a pilot treatment trial of an intervention (e.g., audit and feedback) that could be used to inform the design of a larger trial. This trial would assess if the intervention helps doctors and nurses prescribe guideline-recommended medications to people with leg artery disease and improve their outcomes.