Exploring Referral Pathways In Leg Ulcer Management
Research type
Research Study
Full title
Patients’, carers’, and nurses’ experience of the referral pathway from primary to secondary care in the context of venous leg ulceration.
IRAS ID
270915
Contact name
Mary Wells
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Clinicaltrials.gov Identifier
NIHR300331, NIHR Pre Doctoral Award
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
A venous leg ulcer is defined by The National Institute for Health and Care Excellence (NICE) as ‘a break in the skin below the knee that has not healed within 2 weeks. It affects 1% of the population; increasing to 4% in those over 65 years of age and is responsible for a large number of chronic wounds in the community. Difficulty mobilising, social isolation, and inability to work are examples of the many factors that contribute to the profound effect venous leg ulceration (VLU) can have on a patient’s quality of life.
Costing up to 2% of the annual healthcare budget in Western societies, leg ulcers are managed in the community, predominantly by district nurses, who spend up to 50% of their time attending to patients with leg ulceration. NICE guidelines recommend early referral to a secondary care vascular specialist within 2 weeks of presentation, however the two-week mark for referral is often missed. As a result, patients live with the discomfort and consequences of VLU for much longer than necessary, and outcomes are adversely affected.
As little is known about the reasons for delays in referral, this study will use qualitative research methods (interviews and focus groups) to explore patients’ and carers’ experiences of and concerns about their leg ulcer management, in order to identify barriers and facilitators to early referral. Additionally, we aim to carry out interviews and focus groups with nursing staff to explore their experiences of caring for and referring patients with leg ulcers to secondary care.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
20/LO/0247
Date of REC Opinion
25 Feb 2020
REC opinion
Favourable Opinion