Health‐related quality of life in hospital inpatients with pressure ulceration: Assessment using generic health‐related quality of life measures

Essex, Holly; Clark, Michael; Sims, Joyce; Warriner, Ann; Cullum, Nicky

doi:10.1111/j.1524-475x.2009.00544.x

Cited by 116 publications

(73 citation statements)

References 22 publications

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“…Overall, the mean number of flaws and poorly reported items per study was 13.9, ranging from 7 to 20. Instances of poor reporting accounted for the majority of these (mean 9.4, range [5][6][7][8][9][10][11][12][13]. Studies had an average of 2.9 minor flaws (range 1-5) and 1.5 major flaws (range 0-3).…”

Section: Quality Assessmentmentioning

confidence: 99%

“…We had already shown that pressure ulcers had a measurable (negative) impact on quality of life when people with pressure ulcers were compared with others matched for age and comorbidities. 9 Research had also given some insights into the negative impact on patients of leg 10,11 and foot 12 ulceration.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12] There is evidence from research into other chronic conditions that the outcomes that matter most to patients may not be the primary outcomes measured in RCTs. For example, findings from the OMERACT (Outcome Measures in Rheumatology) collaboration suggest that clinicians and researchers may not realise that certain outcomes are very important for patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Wounds research for patient benefit: a 5-year programme of research

Cullum

Buckley

Dumville

et al. 2016

Programme Grants Appl Res

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BackgroundComplex wounds are those that heal by secondary intention and include lower-limb ulcers, pressure ulcers and some surgical wounds. The care of people with complex wounds is costly, with care mainly being delivered by community nurses. There is a lack of current, high-quality data regarding the numbers and types of people affected, care received and outcomes achieved.ObjectivesTo (1) assess how high-quality data about complex wounds can be captured effectively for use in both service planning and research while ensuring integration with current clinical data collection systems and minimal impact on staff time; (2) investigate whether or not a clinical register of people with complex wounds could give valid estimates of treatment effects, thus reducing dependence on large-scale randomised controlled trials (RCTs); (3) identify the most important research questions and outcomes for people with complex wounds from the perspectives of patients, carers and health-care professionals; (4) evaluate the potential contributions to decision-making of individual patient data meta-analysis and mixed treatment comparison meta-analysis; and (5) complete and update systematic reviews in topic areas of high priority.MethodsTo meet objectives 1 and 2 we conducted a prevalence survey and developed and piloted a longitudinal disease register. A consultative, deliberative method and in-depth interviews were undertaken to address objective 3. To address objectives 4 and 5 we conducted systematic reviews including mixed treatment comparison meta-analysis.ResultsFrom the prevalence survey we estimated the point prevalence of all complex wounds to be 1.47 per 1000 people (95% confidence interval 1.38 to 1.56 per 1000 people). Pressure ulcers and venous leg ulcers were the most common type of complex wound. A total of 195 people with a complex wound were recruited to a complex wounds register pilot. We established the feasibility of correctly identifying, extracting and transferring routine NHS data into the register; however, participant recruitment, data collection and tracking individual wounds in people with multiple wounds were challenging. Most patients and health professionals regarded healing of the wound as the primary treatment goal. Patients were greatly troubled by the social consequences of having a complex wound. Complex wounds are frequently a consequence of, and are themselves, a long-term condition but treatment is usually focused on healing the wound. Consultative, deliberative research agenda setting on pressure ulcer prevention and treatment with patients, carers and clinicians yielded 960 treatment uncertainties and a top 12 list of research priorities. Of 167 RCTs of complex wound treatments in a systematic review of study quality, 41% did not specify a primary outcome and the overall quality of the conduct and reporting of the research was poor. Mixed-treatment comparison meta-analysis in areas of high priority identified that matrix hydrocolloid dressings had the highest probability (70%) of being the most effective dressing for diabetic foot ulcers, whereas a hyaluronan fleece dressing had the highest probability (35%) of being the most effective dressing for venous ulcers; however, the quality of this evidence was low and uncertainty is high.ConclusionsComplex wounds are common and costly with a poor evidence base for many frequent clinical decisions. There is little routine clinical data collection in community nursing. A prospective complex wounds register has the potential to both assist clinical decision-making and provide important research evidence but would be challenging to implement without investment in information technology in NHS community services. Future work should focus on developing insights into typical wound healing trajectories, identifying factors that are prognostic for healing and assessing the cost-effectiveness of selected wound treatments.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Quality Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Wounds research for patient benefit: a 5-year programme of research

Cullum

Buckley

Dumville

et al. 2016

Programme Grants Appl Res

Self Cite

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“…The utility scores of hospitalised patients in the same age group and with intact skin was 0.66, from an Australian study by Hawthorne et al [28]. The reduction in quality of life (ie, disutility) from pressure ulcers was 0.29 based on the study by Essex et al [29].…”

Section: Utilitiesmentioning

confidence: 99%

Cost-Effectiveness and Value of Information Analysis of Nutritional Support for Preventing Pressure Ulcers in High-risk Patients: Implement Now, Research Later

Tuffaha

Roberts

Chaboyer

et al. 2015

Appl Health Econ Health Policy

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“…Attempts to measure changes in HRQL in people with PUs using quantitative data collection methods (i.e. use of generic PRO instruments to evaluate HRQL in PUs) have had inconsistent results; some findings indicate reductions in HRQL for patients with PUs compared to those without [20,21] while others found no differences in HRQL between people with PUs and controls [22,23].…”

Section: Introductionmentioning

confidence: 99%