A scoping review of evidence related to wearing compression stockings for venous insufficiency and venous leg ulcers

Introduction: Occupational Therapists hold a key role in the prescription of compression stockings, but patient adherence to wearing stockings is low. The literature about this phenomenon of adherence lacks coherence and there is little consistency in defining or scoring adherence. Objective: The aim of this scoping review is to bring coherence to a heterogeneous research pool of literature around stocking adherence by developing a conceptual framework, while identifying gaps in the existing literature for future researchers. Method: MEDLINE, CINAHL, Embase, Cochrane, Web of Science, Google Scholar and OTseeker databases were searched using Jabareen’s qualitative methodology. Studies were included that discussed the situation where compression stockings were medically prescribed to manage a lower limb condition requiring long term compression therapy (>12 months) and adherence was discussed as a direct outcome. Results: 2667 articles were initially screened for eligibility resulting in 69 that were ultimately included. A conceptual framework was developed as dominant themes emerged, describing the antecedents to adherence and the outcomes when this phenomenon was influenced. Conclusion: Studies to date have been unable to solve the problem of creating an intervention strategy applicable to a large population where each participant presents with unique barriers to wearing compression. Future research should aim to develop tools to identify unique patient barriers, with the goal of developing personalised intervention strategies to address these in a structured way. Furthermore, the development of a consensus definition of adherence and consistent scoring system in wearing compression stockings would allow researchers to align and compare studies.