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Cost effectiveness of community leg ulcer clinics: randomised controlled trial

Morrell, C.J., Walters, S.J., Dixon, S., Collins, K.A., Brereton, L.M.L., Peters, J. and Brooker, C.G.D. (1998) Cost effectiveness of community leg ulcer clinics: randomised controlled trial. BMJ, 316 (7143). pp. 1487-1491. ISSN 0959-8138

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Abstract

Objectives: To establish the relative cost effectiveness of community leg ulcer clinics that use four layer compression bandaging versus usual care provided by district nurses.

Design: Randomised controlled trial with 1 year of follow up.

Setting: Eight community based research clinics in four trusts in Trent.

Subjects: 233 patients with venous leg ulcers allocated at random to intervention (120) or control (113) group.

Interventions: Weekly treatment with four layer bandaging in a leg ulcer clinic (clinic group) or usual care at home by the district nursing service (control group).

Main outcome measures: Time to complete ulcer healing, patient health status, and recurrence of ulcers. Satisfaction with care, use of services, and personal costs were also monitored.

Results: The ulcers of patients in the clinic group tended to heal sooner than those in the control group over the whole 12 month follow up (log rank P=0.03). At 12 weeks, 34% of patients in the clinic group were healed compared with 24% in the control. The crude initial healing rate of ulcers in intervention compared with control patients was 1.45 (95% confidence interval 1.04 to 2.03). No significant differences were found between the groups in health status. Mean total NHS costs were £878.06 per year for the clinic group and £859.34 for the control (P=0.89).

Conclusions: Community based leg ulcer clinics with trained nurses using four layer bandaging is more effective than traditional home based treatment. This benefit is achieved at a small additional cost and could be delivered at reduced cost if certain service configurations were used.

Item Type: Article
Copyright, Publisher and Additional Information: © BMJ 1998. Reproduced in accordance with the publisher's self-archiving policy.
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Nursing and Midwifery (Sheffield)
The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield)
Depositing User: Repository Officer
Date Deposited: 12 Sep 2006
Last Modified: 08 Feb 2013 16:50
Published Version: http://bmj.com/cgi/content/full/316/7143/1487
Status: Published
Publisher: British Medical Journal Publishing Group
Refereed: Yes
URI: http://eprints.whiterose.ac.uk/id/eprint/1568

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