Venous Leg Ulcer
Conditions
Brief summary
This project aims to investigate 'The minimum diagnostic requirements for patients presenting to primary care with suspected venous ulcers.' In order to do this, the investigators intend to run a series of questionnaires with primary care services, vascular science services, and perform some cost effectiveness modelling on running diagnostic services in primary care and in secondary care settings. A one off questionnaire, designed in Qualtrics, will be sent out to primary care practitioners via social media and email contacts. This will be aimed at establishing their current role and any guidelines they follow with regards to the diagnosis and management of venous leg ulcers in primary care, and to determine their opinion of what this patient pathway should involve. A Delphi consensus will be carried out amongst vascular scientists across the UK to determine current and streamline future practice in diagnostics for patients with venous leg ulcers. The consensus will be achieved when there is ≥ 70% agreement. Cost effectiveness modelling will be carried out on two different scenarios of managing this cohort of patients, one in primary care and one in secondary care settings. Descriptive statistics will be performed on the results.
Detailed description
The main objective of this project is to determine the role/position of diagnostic imaging in the patient journey for a patient with active or healed ulceration. 1. To determine the current practice in primary care for venous leg ulcer management and availability of services to onward referral. 2. To determine the current practice for diagnosis and management of suspected venous leg ulcers in vascular scientist departments across the UK 3. To establish what the minimum diagnostics should be for this cohort of patients including what scans should be performed and can a set criterion be applied to this cohort of patients. 4. To determine the cost effectiveness of implementing this in both primary and secondary care settings.
Interventions
OTHERN/A - Questionnaire based study
Questionnaire based study
Sponsors
Imperial College London
Imperial College Healthcare NHS Trust
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Primary care practitioners working in the UK will be recruited for the primary care questionnaire. * Vascular Scientists working in a secondary care hospital in the UK will be recruited for the online delphi consensus.
Exclusion criteria
* Participants not meeting the inclusion criteria.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary Care Practitioners and the Management of Venous Leg Ulcers. | 3 months | What percentage of respondents have access to onward specialist referral for venous leg ulcer management? What percentage of primary care practitioners have access to refer for venous duplex imaging? What percentage of primary care practitioners felt there needs to be clearer guidelines on the management of patients with venous leg ulcers. |
| Vascular Scientists | 3 months | To determine a consensus on the diagnostic management of suspected venous leg ulcers in vascular scientist departments across the UK. What % of respondents felt there needed to be clearer guidelines on how to best manage these patients diagnostically? What % of respondents felt that specialist leg ulcer clinics should be run? What % felt patients should be able to access an ABPI as part of this clinic? What % felt patients should be able to access a venous duplex scan as part of this clinic? What % felt leg ulcer clinics should be held in secondary |
Countries
United Kingdom
Contacts
PRINCIPAL_INVESTIGATORAlun Davies
Imperial College London
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Primary Care Practitioners A one off questionnaire to be sent to primary care practitioners via qualtrics to determine the current practice in primary care for venous leg ulcer management and availability of services to onward referral.
N/A - Questionnaire based study: Questionnaire based study | 92 |
| Vascular Scientists A Delphi Consensus questionnaire will be performed via Qualtrics to determine the current practice for diagnosis and management of suspected venous leg ulcers in vascular scientist departments across the UK
N/A - Questionnaire based study: Questionnaire based study | 43 |
| Total | 135 |
Baseline characteristics
| Characteristic | Total |
|---|---|
| Race and Ethnicity Not Collected | 0 Participants |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Primary Care Practitioners and the Management of Venous Leg Ulcers.
What percentage of respondents have access to onward specialist referral for venous leg ulcer management? What percentage of primary care practitioners have access to refer for venous duplex imaging? What percentage of primary care practitioners felt there needs to be clearer guidelines on the management of patients with venous leg ulcers.
Time frame: 3 months
Population: The overall response rate was 92, but it was not compulsory to answer every question in the questionnaire, so some questions had different response rates.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Primary Care Practitioners | Primary Care Practitioners and the Management of Venous Leg Ulcers. | What % of respondents have access to onward specialist referral for venous leg ulcer management? | 50 Participants |
| Primary Care Practitioners | Primary Care Practitioners and the Management of Venous Leg Ulcers. | What percentage of primary care practitioners have access to refer for venous duplex imaging? | 34 Participants |
| Primary Care Practitioners | Primary Care Practitioners and the Management of Venous Leg Ulcers. | What % of PCP felt there needs to be clearer guidelines on management of patients with VLUs. | 45 Participants |
Primary
Vascular Scientists
To determine a consensus on the diagnostic management of suspected venous leg ulcers in vascular scientist departments across the UK. What % of respondents felt there needed to be clearer guidelines on how to best manage these patients diagnostically? What % of respondents felt that specialist leg ulcer clinics should be run? What % felt patients should be able to access an ABPI as part of this clinic? What % felt patients should be able to access a venous duplex scan as part of this clinic? What % felt leg ulcer clinics should be held in secondary
Time frame: 3 months
Population: There were 43 responses to the Delphi.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Primary Care Practitioners | Vascular Scientists | What % of respondents felt that specialist leg ulcer clinics should be run? | 33 Participants |
| Primary Care Practitioners | Vascular Scientists | What % of respondents felt there needed to be clearer diagnostic guidelines? | 29 Participants |
| Primary Care Practitioners | Vascular Scientists | What % felt patients should be able to access an ABPI as part of this clinic? | 32 Participants |
| Primary Care Practitioners | Vascular Scientists | What % felt patients should be able to access a venous duplex scan as part of this clinic? | 24 Participants |
| Primary Care Practitioners | Vascular Scientists | What % felt leg ulcer clinics should be held in secondary care? | 22 Participants |
| Primary Care Practitioners | Vascular Scientists | What % felt compression bandaging should be removed before a venous insufficiency scan? | 34 Participants |