Abstract
Introduction/Rationale:
Compression stockings are often prescribed to prevent venous leg ulcer recurrence, but low patient adherence leads to negative health and economic outcomes. To improve adherence, a clinical decision-aid, delivered by occupational therapists, was developed, including the following: an assessment questionnaire to identify the patients' top three barriers to adherence, an algorithm that guides decision making, linking patient-specific barriers with tailored recommendations and resources to guide the development of a tailored treatment plan.
Objectives:
This study aimed to assess methods and feasibility, including the clinical- and cost-effectiveness of a definitive trial.
Method/approach:
A two-arm, single-blinded pilot randomised controlled trial with a health economic evaluation was conducted within two tertiary hospital occupational therapy outpatient clinics. Nineteen participants, demonstrating poor baseline adherence, were randomised to receive either usual-care or the intervention, where the clinician utilised the aid. Each participant received 6 months of care. Stocking-adherence and other clinical outcomes including quality-of-life were measured. Analyses included descriptive and inferential statistics.
Results/practice implications:
The methodology was feasible. The intervention group using the aid showed significantly better adherence than the usual-care group (p = 0.002), with improved adherence strongly correlated with resolving individual patient barriers (p < 0.001). Health utility analysis indicated that while the intervention was slightly more expensive, it was more effective than usual care.
Conclusion:
The study demonstrated the feasibility of the research methodology for a definitive trial. Despite the small sample size, the pilot indicated that the clinical decision-aid has potential for improving stocking adherence in a cost-effective way among individuals at risk of venous leg ulcer recurrence.
Compression stockings are often prescribed to prevent venous leg ulcer recurrence, but low patient adherence leads to negative health and economic outcomes. To improve adherence, a clinical decision-aid, delivered by occupational therapists, was developed, including the following: an assessment questionnaire to identify the patients' top three barriers to adherence, an algorithm that guides decision making, linking patient-specific barriers with tailored recommendations and resources to guide the development of a tailored treatment plan.
Objectives:
This study aimed to assess methods and feasibility, including the clinical- and cost-effectiveness of a definitive trial.
Method/approach:
A two-arm, single-blinded pilot randomised controlled trial with a health economic evaluation was conducted within two tertiary hospital occupational therapy outpatient clinics. Nineteen participants, demonstrating poor baseline adherence, were randomised to receive either usual-care or the intervention, where the clinician utilised the aid. Each participant received 6 months of care. Stocking-adherence and other clinical outcomes including quality-of-life were measured. Analyses included descriptive and inferential statistics.
Results/practice implications:
The methodology was feasible. The intervention group using the aid showed significantly better adherence than the usual-care group (p = 0.002), with improved adherence strongly correlated with resolving individual patient barriers (p < 0.001). Health utility analysis indicated that while the intervention was slightly more expensive, it was more effective than usual care.
Conclusion:
The study demonstrated the feasibility of the research methodology for a definitive trial. Despite the small sample size, the pilot indicated that the clinical decision-aid has potential for improving stocking adherence in a cost-effective way among individuals at risk of venous leg ulcer recurrence.
| Original language | English |
|---|---|
| Article number | 161 |
| Pages (from-to) | e70021 |
| Journal | Australian Occupational Therapy Journal |
| Volume | 72 |
| Issue number | S1 |
| DOIs | |
| Publication status | Published - 23 Jun 2025 |
| Event | Occupational Therapy Australia 31st National Conference and Exhibition 2025 - Adelaide Conference Centre, Adelaide, Australia Duration: 25 Jun 2025 → 27 Jun 2025 Conference number: 31 https://www.otausevents.com.au/otaus2025 |