H.J.P Fokkenrood

Innovative strategies for
intermittent claudication

towards a stepped care approach and new outcome measures



 Stimulating self-management causes the patient to learn and become more engaged in their own health process. This is useful in PAOD treatment, because of the importance of lifestyle changes and a proactive attitude. Implementation of e-Health & m-Health technology is promising and has the potential of a significant reduction in healthcare costs.


 e-Health solutions

 Structural feedback from patients regarding the quality of provided SET in a simple short questionnaire, offers tremendous possibilities (figure 1). For example, patients will be asked about their opinions of involved caregivers (GP, VS, CPH and PT) and the provided SET program. This information is then compared and analysed with objective SET outcome results (maximal walking distance, functional walking distance, QoL surveys).


 To improve the patient's own responsibility in the treatment of PAOD, a part of the numerous SET sessions can be utilized to introduce patients with the personal web-portal. Patients gain access to an online community specifically geared to PAOD patients. This portal brings together a wealth of information for patients through highly accessible online resources. The website will have two components, namely a public domain and a personal portfolio. The public section contains general disease information on PAOD and information regarding treatment modalities (figure 1). Together with a social community platform, where patients can view public profiles and engage with peers, as well as a notice board where patients can post messages for other network participants (figure 1). Patients can exchange experiences, knowledge or even get in touch with each other (by chat, forums or through a video call connection). The personal section allows access to a patient' own journal (with outcome results registered by their PT), their treatment plan and questionnaires in order to monitor, evaluate and benchmark the care provided. It also allows synchronous and asynchronous contact with healthcare providers through modalities as mail, chat and video call.


 M-Health solutions

 The omnipresence of mobile technology offers unique opportunities for the healthcare industry. It has the potential to make healthcare better, faster, cheaper and more accessible. M-Health can improve the quality of care in that it helps patients and clinicians gain a better understanding of the disease through the wealth of personalized information generated by remote health monitoring devices and apps. It increases the access and efficiency by allowing patients and physicians to monitor and analyse (real-time) health data and empowering patients to learn and become engaged in their health

process. Lastly, it can significantly reduce healthcare costs by eliminating unnecessary treatment and facilitating patients to self-manage their condition through automated and highly personal tools.


 ClaudicatioNet is developing a mobile application to augment the patient personal digital portfolio. The 'Walk Mate' app is an innovative application that has several features to help reinforce self-management and patient empowerment through peer support, gamification and telecoaching. The app features an ambient location radar in order to search for fellow patients or volunteers within the WalkMate network, a pre-recorded audio coach for walking advices and stimulation, GPS tracking device to register walking distances and speed, live coaching by (schooled) peers and coach (PT) support through an audio/video call system (figure 1). The diversity and the ability to personalise the available functions, the presence of virtual and live coaching and the facilitation of social interaction and support makes this application a powerful tool in adjunction to SET. Ultimately, outcome parameters of the WalkMate app will be incorporated into the personal patient' portfolio on the personal domain of web portal website (www.etalagebenen.nl). This app will go live in 2013.