Rolland N, Lebrun T, Comte S, Sailly J C
Centre de Recherches Economiques Sociologiques et de Gestion, Lille.
J Mal Vasc. 1999 Jun;24(3):208-13.
Peripheral arterial occlusive disease of the lower limbs results in increased risks of cardiovascular and cerebrovascular morbidity and mortality. However, peripheral arterial disease also has an incapacitating effect upon patients' daily lives, and indeed can have considerable consequences upon their quality of life as well as upon their professional activities. The purpose of this study was to describe patients in terms of their professional activities, the consequences of the disease upon such activities, need for external assistance, and the effects of treatment over a six-month treatment follow-up period. This was a prospective, randomised, double-blind, multicentre study comparing naftidrofuryl (three 200-mg tablets per day) versus placebo in patients presenting with stage-II peripheral arterial disease. Four study visits were scheduled for each patient: an initial selection visit, followed by a 30-day placebo wash-out period, an inclusion visit (to allow verification of inclusion and non-inclusion criteria), and follow-up visits after 3 and 6 months of treatment. 234 patients were included in the study in intention to treat (117 patients in the naftidrofuryl group and 117 patients in the placebo group). These two groups were entirely comparable for all criteria (sociodemographic criteria, risk factors, cardiovascular history, duration of disease) except for obesity and dyslipidaemia, for which prevalence was higher in the naftidrofuryl group. 12.4% of the study population were professionally active at the time of the survey (mean age: 65.9 years). However, 42.3% of patients had in fact been active at the time when arterial disease became manifest. Of these patients, 45.4% (45 patients) stated that arterial disease had affected their professional activity: 28.9% (13 patients) reported a change in their activity, 26.7% (12 patients) reported partial suspension of their activity, and 44.4% (20 patients) stated that all professional activities had ceased. Changes in professional activity comprised invalidity (36.2%), prolonged sick leave (25.5%), premature retirement (14.9%), sick leave (17%), unemployment (6.4%), reduction in long-distance travel (4.3%), change of job (8.5%) or salary reduction (2.1%). During the 6-month follow-up period, only 4 patients were on sick leave (3 in the placebo group and 1 in the naftidrofuryl group). Furthermore, less than 10% of the study population required external assistance as a result of the disease. This analysis thus highlights the repercussions of this disease upon the patients' daily and professional activities.