The humanistic and economic burden of chronic wounds: a protocol for a systematic review

Abstract

BackgroundChronic non-healing wounds present a substantial economic burden to healthcare system; significant reductions in quality of life for those affected, and precede often serious events such as limp amputations or even premature deaths. This burden is also likely to increase with a larger proportion of elderly and increasing prevalence of life-style diseases such as obesity and diabetes. Reviews of the evidence on the burden of illness associated with chronic wounds have not been comprehensive in scope and have not provided an assessment of the distribution of the health care costs across categories of resource use.Methods/designThis study is a systematic review of multiple databases for studies on adult patients with chronic wounds and with the primary objective to assess the impact on health-related quality of life by category of ulcers, and associated direct and indirect costs. Eligible studies will primary be empirical studies evaluating, describing or comparing measurement of quality of life and economic impact. Two reviewers will independently screen titles and abstracts and select studies involving adults with chronic wounds. These investigators will also independently extract data using a pre-designed data extraction form. Differences in applied methodologies and uncertainties will clearly be accounted for. Conservative valuations of costs and impact on health-related quality of life will be prioritised. Variations that may depend on age distribution, the categorisation of ulcer, healthcare system etc. will be described clearly.DiscussionThe proposed systematic review will yield a comprehensive assessment of the humanistic and economic burden of chronic wounds in an adult population. A better understanding of the humanistic and economic burden of chronic wounds is essential for policy and planning purposes, to monitor trends in disease burden and not at least in order to estimate the real-world cost-effectiveness of new treatments and therapies.Systematic review registrationPROSPERO CRD42016037496 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0400-8) contains supplementary material, which is available to authorized users.

Patient education materials on pressure injury prevention in hospitals and health services in Victoria, Australia: Availability and content analysis

“…PIs present a substantial economic burden for the health care sector and reduce health‐related quality of life of patients . Prevention of PIs is a cost‐effective approach for reducing HAPIs and improving patient outcomes .…”

“…Pressure injury (PI), also known as a pressure ulcer, was defined as “a localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear,” (p12) . PI imposes a significant economic and social burden to Australia and globally . The National Pressure Ulcer Advisory Panel, the European Pressure Advisory Panel, and the Pan Pacific Pressure Injury Alliance categorise PIs into six clinical stages (ranging from superficial to deep tissue injuries, including suspected deep tissue injury and unstageable PI); and acknowledge the increase of the negative health impacts with the depth of the PI.…”

Review: Multimodal bioactive material approaches for wound healing

“…1 More specifically, chronic foot ulcers are expected to affect 15% of people diagnosed with diabetes, a multifaceted disease in which the wound healing process is perturbed. 2 Diabetic ulcer management is a leading cause of hospitalization, and in fact, diabetic ulcers are the underlying cause in about 85% of all diabetic limb amputations.…”

“…2 Diabetic ulcer management is a leading cause of hospitalization, and in fact, diabetic ulcers are the underlying cause in about 85% of all diabetic limb amputations. 3 Treatment of diabetic foot ulcers is estimated to cost US$20 billion annually, 1 thus highlighting the economic burden caused by non-healing chronic wounds. Therefore, it is evident that an optimal solution must combine and address multiple biological characteristics associated with wound healing (prolonged inflammation, matrix regeneration, poor angiogenesis, and re-epithelialization).…”

The influence of chronic wound leg on the quality of life of patients // Uticaj hronične rane noge na kvalitet života bolesnika

“…Ovakvo razmišljanje moglo bi doneti promene u preusmeravanja fi nansijskih sredstava i očuvanje zdrave populacije. 2 Svetska Zdravstvena Organizacija godine 1993. definiše kvalitet života kao percepciju pojedinca o sopstvenom položaju u životu u kontekstu kulture i sistema vrednosti u kojem živi kao i u odnosu na sopstvene ciljeve, očekivanja, standarde i interesovanja. To je širok koncept koga čine:…”