Pain and analgesics in patients with hard-to-heal ulcers: using telemedicine or standard consultations

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Pain and analgesics in patients with hard-to-heal ulcers : using telemedicine or standard consultations

Wickström, Hanna (author): Department of Clinical Sciences, Malmö, Centre for Primary Health Care Research, Lund University, Malmö, Sweden ; Blekinge Wound Healing Centre, Karlshamn, Sweden

Öien, Rut F. (author): Blekinge Wound Healing Centre, Karlshamn, Sweden ; Blekinge Centre of Competence, Karlskrona, Sweden

Midlöv, Patrik (author): Department of Clinical Sciences, Malmö, Centre for Primary Health Care Research, Lund University, Malmö, Sweden

Anderberg, Peter (author): Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden

Fagerström, Cecilia (author): Blekinge Centre of Competence, Karlskrona, Sweden ; Department of Health and Caring Sciences, Linnaeus University, Sweden

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Mark Allen Group, 2021
2021
English.
In: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 30:Sup6, s. S23-S32

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Objective:To compare consultations carried out via video with those performed in person for patients with painful, hard-to-heal ulcers, with a focus on ulcer pain and pain treatment. A further aim was to investigate predictors for pain and pain treatment.Method:This was a register-based, quasi-experimental study based on data from the Swedish Registry of Ulcer Treatment (RUT). A total of 100 patients with hard-to-heal ulcers diagnosed via video consultation were compared with 1888 patients diagnosed in person with regard to pain assessment, intensity and treatment. Ulcer pain intensity was assessed by the visual analogue scale (VAS). Normally distributed variables (age, VAS) were compared between consultation groups using Student's t-test. Non-normally distributed variables (ulcer size, ulcer duration) were compared using the Mann–Whitney U-test, except for healing time, which was analysed with a log-rank test. Categorical variables (gender, ulcer aetiology and prescribed analgesics) were compared using Pearson's chi-square test (χ2). A p value of less than 0.05 was considered to indicate statistical significance. Predictors for pain and pain treatment were analysed in multiple regression analyses.Results:The results showed a high presence of pain; 71% of patients with pain reported severe ulcer pain. There was no significant difference in ability to assess pain by VAS in the group diagnosed via video consultation (90%) compared with the group diagnosed in person (86%) (χ2, p=0.233). A significantly higher amount of prescribed analgesics was found for patients diagnosed via video (84%) compared with patients diagnosed by in-person assessment (68%) (χ2, p=0.044). Predictors for high-intensity pain were female gender or ulcers due to inflammatory vessel disease, while the predictors for receiving analgesics were older age, longer healing time and being diagnosed via video consultation.Conclusion:To identify, assess and treat ulcer pain is equally possible via video as by in-person consultation. The results of this study confirm that patients with hard-to-heal ulcers suffer from high-intensity ulcer pain, with a discrepancy between pain and pain relief. Further well-designed randomised controlled studies are necessary to understand how best to deploy telemedicine in ulcer pain treatment.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)

Keyword

analgesics
eHealth
leg ulcer pain
national registries
telemedicine

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ref (subject category)
art (subject category)

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By the author/editor: Wickström, Hanna; Öien, Rut F.; Midlöv, Patrik; Anderberg, Peter; Fagerström, Ceci ...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Nursing

Articles in the publication: Journal of Wound ...

By the university: University of Skövde

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