Patients’ tolerance of leg ulcer treatments.

Little has been published about patients’ tolerance of their venous leg ulcer treatments. That which has, fails to clearly distinguish between ‘tolerance of’ and ‘compliance with’ treatment. As part of a pragmatic randomised trial, treatment tolerance was monitored in a sample of patients with venous leg ulcers receiving either four-layer compression bandage system in a clinic setting (Clinic Group n 120) or receiving their ‘usual’ leg ulcer treatment at home from the district nursing service (Home Group n113). Data were collected weekly for twelve weeks using a structured questionnaire. Log-linear modelling was used for statistical analysis where appropriate. There was a trend for Clinic Group patients overall to be slightly more tolerant of their leg ulcer treatment, although the results were not statistically significant. Overall, Home Group patients had more frequent ulcer dressings; suffered more ulcer infections; suffered more ‘strike through’; dressings allergy, dressings pain and dressings discomfort. Nurses also reported overall worse health status, more illness and a greater number of referrals for the Home Group patients, although again, the results were not statistically significant. The costs associated with these problems have an impact on the cost effectiveness of leg ulcer treatments for patients. Patient’s tolerance of, and compliance with, venous leg ulcer treatments should be monitored. Further investigation is required into patients’ tolerance of compression therapy.