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ABIDING

Ankle Brachial Index Determination by oscillometric method IN General practice

The ABIDING Study will investigate if the oscillometric determination of ankle brachial index (ABI) by general practice nurses is a valid and reliable method.  Practice nurses have been chosen rather than GPs as, with the current GP workforce shortage and the promotion of the concept of a ‘primary care team’ supported by MBS item numbers for nurses, this is more likely to be implementable.  GPs have ready access to oscillometric sphygmomanometers as recently oscillometric sphygmomanometers were distributed to GPs through the High Blood Pressure Research Council of Australia.

 

The REACH registry Australian DMC, located at the Department of Epidemiology and Preventive Medicine, Monash University, will be used to recruit GP practices to participate in the study.  The REACH Registry was an international register of those with established cardiovascular disease or at high risk of it.  It was demonstrated in the REACH Registry that peripheral arterial disease (PAD) is prevalent in high risk individuals in the Australian primary care environment. In addition it was shown that those with the condition had the highest level of cardiovascular disease (CVD) morbidity and mortality over the subsequent year.

 

Oscillometric devices allow Ankle-Brachial index (ABI) measurement without a Doppler device.  We wish to validate these devices in Australian general practice. Secondary aims of the study are to establish the change in prevalence over time of PAD in a defined high risk general practice population, to ascertain the utility of oscillometric devices for the diagnosis of PAD and to monitor the change since baseline of the ABI using the standard technique, BMI, waist circumference measure and Edinburgh Claudication score.  Ethics approval for the study was obtained and the study began recruiting in late 2009, with 13 study participants completing study visits.  This study is funded by an NHMRC grant and is being led by Professor Mark Nelson, University of Tasmania.