Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community populationCitation formats

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@article{2df1dc5e151749b6a2a28bad953ee769,
title = "Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population",
abstract = "Background Complex wounds impose a substantial health economic burden worldwide. As wound care is managed across multiple settings by a range of healthcare professionals with varying levels of expertise, the actual care delivered can vary considerably and result in the underuse of evidence-based interventions, the overuse of interventions supported by limited evidence and low value healthcare.Objectives To quantify the number, type and management of complex wounds being treated over a two-week period and to explore variations in care by comparing current practices in wound assessment, prevention and treatment.Design A multiservice cross-sectional survey.Setting This survey spanned eight community services within five Northern England NHS Trusts.Results The point prevalence of complex wounds in this community-based population was 16.4 per 10 000 (95{\%} CI 15.9 to 17.0). Based on data from 3179 patients, antimicrobial dressings were being used as the primary dressing for 36{\%} of patients with complex wounds. Forty per cent of people with leg ulcers either had not received the recommended Doppler-aided Ankle Brachial Pressure Index assessment or it was unclear whether a recording had been taken. Thirty-one per cent of patients whose most severe wound was a venous leg ulcer were not receiving compression therapy, and there was limited use of two-layer compression hosiery. Of patients with a pressure ulcer, 39{\%} were not using a pressure-relieving cushion or mattress.Conclusions Marked variations were found in care, underuse of evidence-based practices and overuse of practices that are not supported by robust research evidence. Significant opportunities for delivering better value wound care therefore exist. Efforts should now focus on developing strategies to identify, assess and disinvest from products and practices supported by little or no evidence and enhance the uptake of those that are.",
author = "Trish Gray and Sarah Rhodes and Ross Atkinson and Katy Rothwell and Paul Wilson and Joanne Dumville and N Cullum",
year = "2018",
month = "10",
doi = "10.1136/bmjopen-2017-019440",
language = "English",
volume = "8",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ",
number = "3",

}

RIS

TY - JOUR

T1 - Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population

AU - Gray, Trish

AU - Rhodes, Sarah

AU - Atkinson, Ross

AU - Rothwell, Katy

AU - Wilson, Paul

AU - Dumville, Joanne

AU - Cullum, N

PY - 2018/10

Y1 - 2018/10

N2 - Background Complex wounds impose a substantial health economic burden worldwide. As wound care is managed across multiple settings by a range of healthcare professionals with varying levels of expertise, the actual care delivered can vary considerably and result in the underuse of evidence-based interventions, the overuse of interventions supported by limited evidence and low value healthcare.Objectives To quantify the number, type and management of complex wounds being treated over a two-week period and to explore variations in care by comparing current practices in wound assessment, prevention and treatment.Design A multiservice cross-sectional survey.Setting This survey spanned eight community services within five Northern England NHS Trusts.Results The point prevalence of complex wounds in this community-based population was 16.4 per 10 000 (95% CI 15.9 to 17.0). Based on data from 3179 patients, antimicrobial dressings were being used as the primary dressing for 36% of patients with complex wounds. Forty per cent of people with leg ulcers either had not received the recommended Doppler-aided Ankle Brachial Pressure Index assessment or it was unclear whether a recording had been taken. Thirty-one per cent of patients whose most severe wound was a venous leg ulcer were not receiving compression therapy, and there was limited use of two-layer compression hosiery. Of patients with a pressure ulcer, 39% were not using a pressure-relieving cushion or mattress.Conclusions Marked variations were found in care, underuse of evidence-based practices and overuse of practices that are not supported by robust research evidence. Significant opportunities for delivering better value wound care therefore exist. Efforts should now focus on developing strategies to identify, assess and disinvest from products and practices supported by little or no evidence and enhance the uptake of those that are.

AB - Background Complex wounds impose a substantial health economic burden worldwide. As wound care is managed across multiple settings by a range of healthcare professionals with varying levels of expertise, the actual care delivered can vary considerably and result in the underuse of evidence-based interventions, the overuse of interventions supported by limited evidence and low value healthcare.Objectives To quantify the number, type and management of complex wounds being treated over a two-week period and to explore variations in care by comparing current practices in wound assessment, prevention and treatment.Design A multiservice cross-sectional survey.Setting This survey spanned eight community services within five Northern England NHS Trusts.Results The point prevalence of complex wounds in this community-based population was 16.4 per 10 000 (95% CI 15.9 to 17.0). Based on data from 3179 patients, antimicrobial dressings were being used as the primary dressing for 36% of patients with complex wounds. Forty per cent of people with leg ulcers either had not received the recommended Doppler-aided Ankle Brachial Pressure Index assessment or it was unclear whether a recording had been taken. Thirty-one per cent of patients whose most severe wound was a venous leg ulcer were not receiving compression therapy, and there was limited use of two-layer compression hosiery. Of patients with a pressure ulcer, 39% were not using a pressure-relieving cushion or mattress.Conclusions Marked variations were found in care, underuse of evidence-based practices and overuse of practices that are not supported by robust research evidence. Significant opportunities for delivering better value wound care therefore exist. Efforts should now focus on developing strategies to identify, assess and disinvest from products and practices supported by little or no evidence and enhance the uptake of those that are.

U2 - 10.1136/bmjopen-2017-019440

DO - 10.1136/bmjopen-2017-019440

M3 - Article

VL - 8

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 3

ER -