| アブストラクト | OBJECTIVE: To assess clinical outcomes and cost-effectiveness of using a two-layer cohesive compression bandage (TLCCB; Coban 2) compared with a two-layer compression system (TLCS; KTwo) and a four-layer compression system (FLCS; Profore) in treating newly-diagnosed venous leg ulcers (VLUs) in clinical practice in the UK, from the perspective of the NHS. METHOD: This was a retrospective cohort analysis of the case records of patients with newly-diagnosed VLUs randomly extracted from The Health Improvement Network (THIN) database (a nationally representative database of clinical practice among patients registered with general practitioners in the UK) who were treated with either TLCCB (n=200), TLCS (n=200) or FLCS (n=200). The clinical outcomes and cost-effectiveness of the alternative compression systems were estimated over six months after starting treatment. RESULTS: Patients' mean age was 72 years and 58% were female. Time from wound onset to the start of compression was a mean of two months, and when starting compression the wound size was a mean of 45 cm(2). The distribution of healing was significantly different between the three groups; 76% of wounds in the TLCCB group healed by six months compared with 70% and 64% in the TLCS and FLCS groups, respectively (p=0.006). Time to healing was significantly less in the TLCCB group compared with the two other groups (p=0.003). Patients in the TLCCB group experienced better health-related quality of life over six months (0.413 quality-adjusted life years (QALYs) per patient), compared with the TLCS and FLCS groups (0.404 and 0.396 QALYs per patient, respectively). The mean six-month NHS management cost was pound3045, pound3842 and pound4480 per patient in the TLCCB, TLCS and FLCS groups, respectively. CONCLUSION: Real-world evidence demonstrates that treating newly-diagnosed VLUs with TLCCB, compared with the other two compression systems, affords a more cost-effective use of NHS-funded resources in clinical practice since it resulted in an increased healing rate, better health-related quality of life and a reduction in NHS management cost. |
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| ジャーナル名 | Journal of wound care |
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| Pubmed追加日 | 2017/5/6 |
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| 投稿者 | Guest, J F; Fuller, G W; Vowden, P |
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| 組織名 | Director of Catalyst, Visiting Professor of Health Economics; Catalyst Health;Economics Consultants, Northwood, Middlesex, UK; Faculty of Life Sciences and;Medicine, King's College, London, UK.;Research Assistant; Catalyst Health Economics Consultants, Northwood, Middlesex,;UK.;Consultant Vascular Surgeon, Professor of Wound Healing Research; Bradford;Teaching Hospitals NHS Foundation Trust and University of Bradford, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28475441/ |
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