Collaboration brings awareness to little known disease

York University researchers in collaboration with and clinicians from the Division of Vascular Surgery at St. Michael’s Hospital in Toronto have embarked on an innovative community-based research project to tackle a deadly, but little known condition called Peripheral Arterial Disease (PAD).

The first of this multi-phase project, titled “Raising Awareness of Peripheral Arterial Disease (PAD) through Community Intervention, Education, Technology, Disease Management and Policy Change,” entails conducting a public outreach survey aimed at testing the public’s knowledge and establishing a base line of public awareness about PAD.

Christo El Morr
Christo El Morr

Principal investigator and York Professor Christo El Morr of the School of Health Policy and Management in the Faculty of Health, says, “The survey will allow the research team to test the public’s knowledge and attitude towards a severe and life-altering vascular disease and to create a framework for policy changes, including funding for family physicians to screen, treat and manage patients with the condition.”

Peripheral Arterial Disease, also known as Peripheral Vascular Disease, Atherosclerotic Peripheral Arterial Disease, or Claudication, impacts an estimated 800,000 Canadians. However, only one in four people with PAD experience classic symptoms, which make early detection even harder.

A recent study found that only 35.5 per cent were somewhat familiar with PAD. When questioned further, poor knowledge of PAD risk factors and complications became evident in the study sample.

PAD is a highly prevalent, progressive atherosclerotic disease that carries a high risk of stroke, myocardial infarction and premature death. Accurate diagnosis of PAD could provide an early indication of the need for intervention and help prevent future morbidity and mortality.

Currently in Ontario, patients are not being screened for the condition. The lack of screening means patients could go undiagnosed. Complications from PAD include tissue loss in the form of ulceration of gangrene, which may lead to amputation. Systemic complications include heart attacks, stroke and kidney artery disease.

Chronic conditions like PAD cost the Canadian economy more than $90 billion a year in lost productivity and health-care costs. Preventing and treating PAD is less costly than treating the complications from a heart attack or stroke. Patients who are screened can be treated with medication and managed over time for a few thousand dollars versus several thousand dollars to treat a stroke patient.

Dr. Mohammed Al-Omran, head, division of vascular surgery at St. Michael’s Hospital says, “Public health issues continue be a major concern. Patients are living longer, but they have more illnesses to manage. These factors place an additional strain on our healthcare institutions. As a teaching hospital and one of Canada’s leading centers for research, we recognize that our approach to disease management must begin at the community level and also that we must be more proactive versus reactive in our approach.”

PAD patients may have intermittent claudication, which is pain in one or both calf muscles that appear with walking and improve with rest. It may or may not be associated with numbness, as well as coldness, of legs or feet. It progresses with time if left untreated to appear even at rest, and the patient may notice skin breaks (ulcers) in the affected areas.

The results of this study will lead to the development of evidence-based education and self-management tools to promote early screening, prevention, symptom awareness, treating and tracking to improve the quality of care and management of the disease.

The study is funded by Ontario Centres of Excellence (OCE) and Ontario Centres of Excellence, support and invests in early-stage projects, where the probability of commercial success and potential total return on innovation are substantial.

The public survey phase will run from Sept. 10 to Oct. 31. It will target participants that are representative of Canada’s diverse population. Participant knowledge of the condition, age, socio-economic status, gender, access to web and mobile technologies and the use of those technologies to access medical information and to communicate with medical practitioners are all factors being examined. Survey participants will come from community centres across the Greater Toronto Area and Toronto City Hall.

Courtney Cole, founder of, says, “ will benefit significantly from the collaboration. We continue to develop virtual clinical pathways for patients to receive education, treatment, coaching in the management of their condition. When completed, the results of this study will undoubtedly lead to the identification of new applications and tools to improve the quality of care for patients with PAD.”

The research team is completed by Dr. Musaad Al-Hamzah, resident; Peggy Suk-Lan Tin Ng, professor of applied statistics and management science at York University; and Shamhad Abdi, research assistant.