Cost-effectiveness of community leg ulcer clinics: a randomised controlled trial

MORRELL, C. J., WALTERS, S. J., DIXON, S., COLLINS, K., BRERETON, L., PETERS, J. and BROOKER, C. G. D. (1998). Cost-effectiveness of community leg ulcer clinics: a randomised controlled trial. British medical journal (BMJ), 7143, 1487-1491.

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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
Research Institute, Centre or Group - Does NOT include content added after October 2018: Centre for Health and Social Care Research
Page Range: 1487-1491
Depositing User: Karen Collins
Date Deposited: 08 Apr 2010 14:15
Last Modified: 18 Mar 2021 21:30

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