Monash Nursing and Midwifery, Melbourne, Victoria, Australia.
School of Psychology, University of Birmingham, Birmingham, UK.
Wound Repair Regen. 2020 Jul;28(4):553-560. doi: 10.1111/wrr.12820. Epub 2020 Apr 30.
Venous Leg Ulcers cost Australia's healthcare system millions yearly, as they are underdiagnosed, and possibly undertreated. Most Venous Leg Ulcers are seen in general practice. However, it is currently unknown as to what treatment actions are most common in these contexts. Understanding how they are managed in these settings can improve healthcare delivery and patient outcomes. Using cross-sectional general practitioner patient encounter data collected April 2006 to March 2016 from the Bettering the Evaluation and Care of Health program, a continuous national study of general practice clinical activity in Australia, we aimed to describe the characteristics of venous leg ulcer management by general practitioners in Australia. Among the 972 100 general practitioner-patient encounters recorded, 3604 (0.34%) involved management of VLU. Male general practitioners managed Venous Leg Ulcers significantly more often than female general practitioners. Most Venous Leg Ulcers were treated via dressings (76%) and/or pharmacological treatments (25.7%), with few patients receiving the best practice treatment of medical compression (2.1%) or referral (4.9%). Patients with new (first visit) Venous Leg Ulcers were more likely to receive pharmacological treatments and to be referred elsewhere, and less likely to receive dressings than patients receiving follow-up care. There appears to be a large gap between best practice guidelines and actual Venous Leg Ulcers treatments, as referrals and appropriate treatment was low. Further longitudinal studies are needed to determine the effectiveness of care for people with Venous Leg Ulcers who are managed by general practitioners.
静脉溃疡每年使澳大利亚的医疗保健系统花费数百万美元,因为它们被漏诊,且可能治疗不足。大多数静脉溃疡在普通科诊所中被发现。然而,目前尚不清楚在这些情况下最常见的治疗措施是什么。了解这些环境中的管理方法可以改善医疗保健的提供和患者的预后。我们使用了 2006 年 4 月至 2016 年 3 月从 Bettering the Evaluation and Care of Health 计划(澳大利亚普通科临床活动的一项全国性连续研究)收集的横截面普通科医生患者就诊数据,旨在描述澳大利亚普通科医生对静脉溃疡管理的特点。在记录的 972100 次普通科医生-患者就诊中,有 3604 次(0.34%)涉及静脉溃疡的管理。男性普通科医生管理静脉溃疡的频率明显高于女性普通科医生。大多数静脉溃疡通过敷料(76%)和/或药物治疗(25.7%)进行治疗,很少有患者接受最佳的医学压迫治疗(2.1%)或转介(4.9%)。新(首次就诊)静脉溃疡患者更有可能接受药物治疗和转介到其他地方,而接受敷料治疗的可能性比接受随访护理的患者低。最佳实践指南与实际静脉溃疡治疗之间似乎存在很大差距,因为转介和适当的治疗率较低。需要进一步进行纵向研究,以确定由普通科医生管理的静脉溃疡患者的护理效果。