RT Journal Article
SR Electronic
T1 Management and outcomes among patients with hard-to-heal ulcers in Sweden: a national mapping of data from medical records, focusing on diagnoses, ulcer healing, ulcer treatment time, pain and prescription of analgesics and antibiotics
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e087894
DO 10.1136/bmjopen-2024-087894
VO 14
IS 8
A1 Öien, Rut Frank
A1 Roxenius, Jenny
A1 Boström, Maria
A1 Wickström, Hanna Linnea
YR 2024
UL http://bmjopen.bmj.com/content/14/8/e087894.abstract
AB Objective To investigate whether patients with hard-to-heal ulcers in Sweden were treated according to an aetiological diagnosis and to explore ulcer healing, treatment time, ulcer-related pain and the prescription of analgesics and antibiotics.Design A national mapping of data from the patients’ medical records, between April 2021 and March 2023.Setting Data from medical records for patients with hard-to-heal ulcers from a randomised clustered sample of two units per level of care and region.Participants Patients with hard-to-heal ulcers treated in primary, community and specialist care, public or private, within units covering all 21 regions in Sweden.Outcome measures Descriptive analysis of data from the patients’ medical records.Results A total of 2470 patients from 168 units were included, of which 39% were treated in primary care, 24% in community care and 37% in specialist care. A total of 49% of patients were treated without an aetiological diagnosis. Healing occurred in 37% of patients and ulcer-related pain was experienced by 1224 patients (50%). Antibiotics were given to 56% of the patients. Amputation occurred in 5% and 11% were deceased.Conclusion Only 51% of patients with hard-to-heal ulcers had a documented aetiological ulcer diagnosis, which means that approximately 20 000 patients in Sweden might receive suboptimal treatment. Future research needs to explore why so many patients are undiagnosed and how to improve diagnosis, which could lead to faster healing and shorter treatment times.All data relevant to the study are included in the article or uploaded as online supplemental information.