Clinical Practice and attitudes regarding the diagnosis of Peripheral Arterial Disease (PAD) - A scoping review

Peripheral arterial disease (PAD) is a chronic atherosclerotic condition in which fatty deposits build up inside arteries, resulting in reduced blood flow to the limbs, affecting 20% of people over 60 in the UK. More than 50% of symptomatic PAD patients are expected to have a major cardiovascular event (myocardial infarction or stroke), or amputation within five years of diagnosis. In the context of ageing population, many of whom present with multiple comorbidities, the prevalence and burden of PAD are expected to rise. Early diagnosis and management for PAD are important for clinical outcomes. The 2025 NHS 10-Year Plan promotes moving services closer to patients in the community and prioritising prevention to identify and address risks earlier, making healthier choices easier and more accessible. However, vascular service provision remains fragmented. Secondary care clinicians advocate for the chronic management of vascular patients within primary care to allow secondary care to focus on acute and complex cases; however, primary care clinicians have indicated that they do not currently have the relevant equipment or expertise to diagnose and manage vascular patients in the community. It is then important to systematically assess the clinical practices and confidence of primary care clinicians to diagnose PAD.