Identifying barriers and facilitators to follow-up after endovascular aortic repair (EVAR): Qualitative study design and protocol
Amanda R. Phillips,
Lindsey A. Olivere,
Marissa C. Jarosinski,
Jackie L. Barnes,
Salim Habib,
Edith Tzeng,
Kimberly J. Rak,
Nathan L. Liang
Affiliations
Amanda R. Phillips
Division of Vascular Surgery, Temple Health, 3509N. Broad Street, Boyer Pavilion, 4th Floor, Philadelphia, PA 19140, United States
Lindsey A. Olivere
Division of Vascular Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, E362.4, South Tower PUH, Pittsburgh, PA 15213, United States
Marissa C. Jarosinski
Division of Vascular Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, E362.4, South Tower PUH, Pittsburgh, PA 15213, United States; Corresponding author.
Jackie L. Barnes
University of Pittsburgh, 3550 Terrace Street. Alan Magee Scaife Hall, Suite 600, Pittsburgh, PA 15213, United States
Salim Habib
Department of Surgery, Allegheny Health Network, 320 East North Avenue, Suite 556, Pittsburgh, PA 15212, United States
Edith Tzeng
Division of Vascular Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, E362.4, South Tower PUH, Pittsburgh, PA 15213, United States; University of Pittsburgh, 3550 Terrace Street. Alan Magee Scaife Hall, Suite 600, Pittsburgh, PA 15213, United States
Kimberly J. Rak
University of Pittsburgh, 3550 Terrace Street. Alan Magee Scaife Hall, Suite 600, Pittsburgh, PA 15213, United States
Nathan L. Liang
Division of Vascular Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, E362.4, South Tower PUH, Pittsburgh, PA 15213, United States; University of Pittsburgh, 3550 Terrace Street. Alan Magee Scaife Hall, Suite 600, Pittsburgh, PA 15213, United States
Endovascular aortic repair (EVAR) is now first line therapy for most patients with abdominal aortic aneurysms (AAA) as it reduces perioperative morbidity and mortality compared to open surgery. However, up to 40 % of patients do not undergo recommended follow-up, increasing risk of subsequent rupture. Risk factors for loss to follow-up have been studied retrospectively, however, qualitative studies assessing perceived barriers and facilitators to follow-up have not been performed and there are few qualitative protocols within the vascular surgery literature. This article presents a qualitative descriptive study protocol aimed at understanding and improving post-operative follow-up adherence after EVAR developed through an iterative process based on the Theoretical Domains Framework of behavior change. Steps include: • Selection of target behavior and study design • Development of study materials, sampling/recruitment strategy, and data collection • Qualitative data analysis and reporting findingsWe demonstrate the feasibility of this study by pilot testing of the semi-structured interview guides on a small group of patients, healthcare providers, and key personnel. This protocol aims to describe key stakeholder experiences within the healthcare system that will ultimately serve as the basis for future multi-institutional research piloting intervention strategies to improve EVAR follow-up.
