Abbott Focuses On Improving Early Diagnosis Of Vascular Disease To Improve Outcomes

Original from: Medtech Insight

Image Credit: Abbott

To improve outcomes for patients with vascular disease, patients need accurate diagnoses and coordinated care early in their “patient journey,” Abbott concluded in its latest Beyond Intervention report.

“We can raise awareness about some of the gaps in patient care, and hopefully drive some positive change for the entirety of the industry,” Nick West, chief medical officer for Abbott’s vascular business, told Medtech Insight. “This is a conversation that not enough medtech companies engage in.”

Abbott released its first Beyond Intervention report in 2020 based on 1,400 patients, physicians and health care executives in the US, UK, China, Japan, France, Germany, India, Italy and Brazil. Those survey results showed patients treated for vascular disease are frequently frustrated by the level of care they receive and want a more personalized experience across the health care continuum.

From April to June 2021, the company conducted another survey of 1,289 people suffering from vascular diseases across 13 countries as well as 408 physicians and 173 health care administrators.

These survey results reveal a significant gap between how patients with coronary or peripheral vascular disease perceive their care versus how physicians and administrators perceive it.

“Patients uniformly report that there are more problems than either the doctors or health care administrators [reported],” West said. “There is a great urgency … for health care providers and med tech companies to try and improve the holistic patient experience.”

For example, only 44% of coronary disease patients surveyed reported that their treatment experience “went as well as it could have,” while 52% of physicians and 64% of administrators reported they believed that the current coronary disease patient experience is “ideal.”

The survey results showed that 38% of the peripheral disease patients believed their treatment experience was as good as it could be and 37% of physicians said the treatment of peripheral disease patients is ideal, but 65% of the administrators surveyed said the peripheral disease patient experience is ideal.

“That's quite concerning – administrators think everyone gets a ‘great deal’ while patients are thinking, ‘Actually, we don't get a great deal,’” West explained.

Abbott markets a range of devices for both coronary and peripheral intervention, including stents, catheters, guidewires, intravascular imaging systems, vessel closure devices and embolic protection systems, “but the Beyond Intervention program has taught us that we need to widen our scope slightly,” he explained. “We can't just think that [patients] begin when they enter the ‘cath lab’ and end when they leave the cath lab. There has to be more to it than that.”

Beyond Intervention is part of Abbott’s company-wide effort to increase its impact on global health and help more patients over the long term. Abbott currently serves two billion people worldwide, but it plans to serve three billion by 2030, West said. (Also see "Big Cardio Medtechs Are Moving ESG Agenda To Center Stage In 2022" - In Vivo, 2 Dec, 2021.)

Patients Need Faster Diagnosis And Clearer Communication

To improve long-term outcomes, patients need to be accurately diagnosed long before they need an urgent intervention.

“Successful patient outcomes depend on the earliest stages of the care continuum,” West said.

About a quarter of the physicians surveyed said they lack adequate technology or equipment to consistently and accurately diagnose vascular disease and one-third of administrators believe that the lack of a widely accepted, standardized approach for diagnosing vascular disease is a major obstacle to accurate diagnoses.

The survey responses from patients showed a general lack of awareness of the symptoms of vascular disease and the available treatment options. About one in five patients surveyed said they had been misdiagnosed, on average, three times before receiving the right diagnosis for their symptoms.

The patients surveyed also reported that they are dissatisfied with the amount of “face time” they have with their physicians, and they are unhappy with the apparent lack of communication between their primary care physicians and their specialists.

West pointed out that the symptoms or peripheral artery disease are generally less well-known than the most common symptoms of coronary disease, so they are more “insidious,” and patients are often not aware that they have peripheral vascular disease until they have foot ulcer or another major adverse event.

“[Peripheral disease] is an unseen killer, because critical limb ischemia leads to high rates of amputation and those patients have a high rate of mortality afterwards.”

Disparities In Care

Abbott’s post-hoc analysis of the survey results also highlighted the disparities in care among different social and ethnic groups. Patients with vascular disease who identify as part of an underserved population report significantly more emotional impacts than their non-underserved counterparts. Female patients also reported significantly more difficulties with the health care system.

Abbott’s vascular division recently announced a series of initiatives to reduce barriers to clinical trial participation for underrepresented groups, includes the creation of nearly 300 new scholarships at medical schools of historically black colleges and universities and minority nursing associations. (Also see "Abbott Wants To Expand Clinical Trial Access By Diversifying Investigator Community" - Medtech Insight, 8 Nov, 2021.)

“People who do get health care get a reasonably good deal, but those who can’t get it, get an absolutely terrible deal across the board,” West explained. “[So we] are not only trying to improve people’s medical literacy, but also improve communication and do all we can to improve access to health care.”

Clinical studies have shown that patients with a clear diagnosis of vascular disease will report less severe symptoms than patients who have not been given a clear diagnosis.

“If patients understand what's being managed and they understand that there may be some symptoms, [they are more likely to believe] the doctor has a handle on it,” he explained. “It's about perception. It's about communication, both within the medical specialties and by the medical specialties with the patient.

Abbott Looks For Ways To Apply AI, Digital Health To Improve Outcomes

West offered some examples of how Abbott is applying technology to improve patient outcomes outside of its traditional focus on interventional devices.

The company is planning to add artificial intelligence software to its line of optical coherence tomography (OCT) intravascular imaging products to allow more physicians, including those who are not specifically trained on OCT, to use intravascular imaging to accurately diagnose vascular disease. [(A#MT122538])

“[The software] will effectively do a lot of the physicians’ work for them,” he said. “It enables them to do a much better intervention without having to be a specialist in the use of the tool.”

Abbott is also developing artificial intelligence and machine learning tools that are used to help physicians identify which patients need interventions. For example, researchers analyzed results of the XIENCE V USA database trial to create a machine learning tool that can help predict target lesion failure in patients treated with Abbott’s Xience V everolimus-eluting coronary stent.

“That’s very simple, but it’s a proof-of-concept for us internally to see if we can look at the data sets we [already] have and uncover … insights that can be useful in a very easy way for clinicians,” he said.

Abbott expects that digital health technologies, including consumer devices like smart watches and smart phones and telehealth technologies can help resolve some of these communication problems.

“With increasing ‘consumerization,’ of health care, patients are taking hold of their own health care and using tools that can provide measurable outputs. And they are demanding that those become part of their patient record and part of their management strategy,” West said. “This is a kind of rallying call for medtech to get involved with this, but also for the health care providers to kind of step up to the plate and allow those things to be part of the overall health care journey. … We all need to keep pace with that.”

Source: Abbott Focuses On Improving Early Diagnosis Of Vascular Disease To Improve Outcomes

Perception Changes Reality

West explained that patients’ frustrations with the health care system can directly affect their outcomes.

“We've got to make sure that whatever the treatment is, that it improves the patient's quality of life, their symptoms, and how they feel, and there is absolutely no doubt that their perception of how they're being managed hugely impacts what they feel about their experience [overall] and probably how they manifest their symptoms,” West said.