Concordance treatment continuum: A proposed clinical outcome to boost concordance with compression therapy

Area of Science:

• Vascular Medicine
• Dermatology
• Public Health

Background:

• Chronic venous insufficiency (CVI) affects 1-3% of the population.
• Venous leg ulcers (VLUs) develop in 60-80% of CVI patients.
• Low patient adherence (39.9%) to compression therapy (CT) leads to VLU recurrence and increased healthcare costs.

Purpose of the Study:

• To identify factors influencing long-term patient concordance with compression therapy for venous leg ulcers.
• To explore clinician and patient perspectives on barriers and facilitators to CT adherence.
• To inform the development of a clinical guideline for improved VLU management.

Main Methods:

• Two Delphi studies were conducted to gather expert consensus.
• A total of 105 factors influencing CT concordance were identified.
• Analysis focused on consensus areas including comfort, motivation, healthcare access, and clinician attributes.

Main Results:

• Clinicians and patients identified distinct factors affecting long-term CT concordance.
• Consensus was reached on factors related to patient comfort, motivation, healthcare accessibility, and clinician characteristics.
• Understanding these factors is crucial for addressing the challenge of VLU recurrence.

Conclusions:

• Improving long-term concordance with compression therapy is essential for managing venous leg ulcers.
• A comprehensive approach addressing patient and clinician factors is needed.
• Further research should integrate identified factors into clinical guidelines to enhance VLU treatment outcomes and reduce recurrence.