Referrals for CLTI: qualitative study

  • Research type

    Research Study

  • Full title

    The experiences of patients with chronic limb-threatening ischaemia from first symptom to vascular surgery assessment: a qualitative study

  • IRAS ID

    321794

  • Contact name

    Eleanor Atkins

  • Contact email

    eatkins@rcseng.ac.uk

  • Sponsor organisation

    University of Hull

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Research Summary:
    Chronic limb-threatening ischaemia (CLTI) is a condition where there is a severe lack of blood supply to the leg. It causes constant pain, ulcers that don’t heal or gangrene, usually in the affected foot. People with this condition are at high risk of dying or losing their leg. Chances of survival and keeping the leg can be improved by doing an operation or procedure to increase blood supply to the foot. National and international guidance recommends urgent referral to vascular surgery services if CLTI is suspected. However, there are delays in the treatment pathway of a person with CLTI at every stage from the first symptom developing to the operation or procedure, and these delays lead to worse outcomes such as major limb amputation.

    This study focusses on the part of the pathway from the patient presenting to primary care services with a symptom of CLTI to assessment by the vascular surgery services. Interviews with up to 20 patients who have been diagnosed with CLTI will explore perceptions and experience of current and alternative features of referral pathways by discussing lived experience and identifying where there are opportunities to improve processes for patients and staff.

    Patients diagnosed with CLTI in the last year will be identified by NHS vascular surgery clinicians and asked if they would be happy for the research team to contact them. Interviews will be held online, over the phone or in person at the participant's choice.

    Lay summary of study results:
    16 participants were interviewed, and these interviews were recorded. The recorded interviews were transcribed into text and analysed by reflective thematic analysis, a method of qualitative analysis. Themes, or shared meanings generated from the data included: CLTI is a devastating condition; Reluctance to ask for help; Luck plays a role in the process to diagnosis; When we are empowered we get better care; Vascular units can do better. These themes are linked following reflection on the participant data, specifically with a thread of awareness, from the general public to healthcare professionals, via patients experiencing the condition.

  • REC name

    Yorkshire & The Humber - South Yorkshire Research Ethics Committee

  • REC reference

    22/YH/0290

  • Date of REC Opinion

    19 Jan 2023

  • REC opinion

    Further Information Favourable Opinion