Long-term observational study on outpatient treatment of venous diseases with medical compression stockings in Germany

Summary

Background As detailed data are lacking on the provision of medical compression stockings (MCSs) in outpatient therapy of venous disorders in Germany, we examined various application parameters of mediven® roundknit garments in an 18-month observational study.

Results Findings possibly indicative of impaired tolerability (dry skin [26.5–29.6 %], transient skin irritation [1.3–2.7 %]) were rare and decreased during the course of the study. The number of patients reporting a marked improvement during the past 12 months increased by 41.5–46.1 %, irrespective of the CEAP classification. Up to 84.5 % of participants reported that their well-being remained at a constantly high level, and the CEAP class improved objectively in 17.7 % of participants. The participants were prescribed an average of four prescriptions for MCSs (mainly compression class 2) which, irrespective of the CEAP and BMI, were mostly of a light quality. During the study, 65.3–75.6 % of patients wore the MCSs every day.

Conclusion Our data show that mediven® MCSs are very well tolerated and lead to a subjective improvement in symptoms. Nevertheless, our results clearly confirm the need to optimise provision to patients with venous disorders.

Keywords

Medical compression stocking - medical care situation - tolerability - compliance

• References

• 1 Rabe E, Pannier-Fischer F, Bromen K. et al. Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie. Phlebologie 2003; 32: 1-14.
• 2 Wienert V, Gerlach H, Gallenkemper G. et al. Leitlinie: Medizinischer Kompressionsstrumpf (MKS). Phlebologie 2006; 35 (06) 315-320.
• 3 Lattimer CR, Azzam M, Kalodiki E. et al. Compression stockings significantly improve hemodynamic performance in post-thrombotic syndrome irrespective of class or length. J Vasc Surg 2013; 58 (01) 158-165.
• 4 Partsch H, Blaettler W. Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg 2000; 32 (05) 861-869.
• 5 Benigni JP, Sadoun S, Allaert FA. et al. Efficacy of Class 1 elastic compression stockings in the early stages of chronic venous disease. A comparative study. Int Angiol 2003; 22 (04) 383-392.
• 6 Vandongen YK, Stacey MC. Graduated compression elastic stockings reduce lipodermatosclerosis and ulcer recurrence. Phlebology 2000; 15: 33-37.
• 7 Cullum N, Nelson EA, Fletcher AW. et al. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2001 02. CD000265.
• 8 Diehm C, Trampisch HJ, Lange S. et al. Comparison of leg compression stocking and oral horsechestnut seed extract therapy in patients with chronic venous insufficiency. Lancet 1996; 347 8997 292-294.
• 9 Belcaro G, Cesarone MR, Shah SS. et al. Prevention of edema, flight microangiopathy and venous thrombosis in long flights with elastic stockings. A randomized trial: The LONFLIT 4 Concorde Edema-SSL Study. Angiology 2002; 53 (06) 635-645.
• 10 Brandjes DP, Bueller HR, Heijboer H. et al. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet 1997; 349 9054 759-762.
• 11 Travers JP, Makin GS. Reduction of varicose vein recurrence by use of postoperative compression stockings. Phlebology 1994; 04: 104-107.
• 12 Scurr JH, Coleridge-Smith P, Cutting P. Varicose veins: optimum compression following sclerotherapy. Ann R Coll Surg Engl 1985; 67 (02) 109-111.
• 13 Shouler PJ, Runchman PC. Varicose veins: optimum compression after surgery and sclerotherapy. Ann R Coll Surg Engl 1989; 71 (06) 402-404.
• 14 Partsch B, Partsch H. Compression stockings for treating venous leg ulcers: measurement of interface pressure under a new ulcer kit. Phlebology 2008; 23 (01) 40-46.
• 15 Nelson EA, Bell-Syer SE. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev. 2012 08. CD002303.
• 16 Pannier F, Hoffmann B, Stang A. et al. Prevalence and acceptance of therapy with medical compression stockings in the adult population – results from the Bonn vein study. Phlebologie 2007; 36: 245-249.
• 17 Raju S, Hollis K, Neglen P. Use of compression stockings in chronic venous disease: patient compliance and efficacy. Ann Vasc Surg 2007; 21 (06) 790-795.
• 18 Ziaja D, Kocelak P, Chudek J. et al. Compliance with compression stockings in patients with chronic venous disorders. Phlebology 2011; 26 (08) 353-360.
• 19 Rabe E, Hertel S, Bock E. et al. Therapy with compression stockings in Germany – results from the Bonn Vein Studies. J Dtsch Dermatol Ges 2013; 11 (03) 257-261.
• 20 Dt. Register Klinischer Studien (DRKS). Eine nicht-interventionelle Studie der mediven®-Kompressionsstrümpfe zur Frage der Produktsicherheit und Compliance bei Patienten mit phlebologischer Erkrankung in ambulanter Versorgung nach § 23b MPG 2014 [cited: 24.03.2015]. Available from: https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006124 .
• 21 Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg 1995; 21 (04) 635-645.
• 22 Guex JJ, Zimmet SE, Boussetta S. et al. Construction and validation of a patient-reported outcome dedicated to chronic venous disorders: SQOR-V (specific quality of life and outcome response – venous). J Mal Vasc 2007; 32 (03) 135-147.
• 23 Reich-Schupke S, Murmann F, Altmeyer P. et al. Quality of life and patients’ view of compression therapy. Int Angiol 2009; 28 (05) 385-393.
• 24 Clarke-Moloney M, Keane N, O’Connor V. et al. Randomisierte kontrollierte Studie mit Vergleich von Kompressionsstrümpfen der Europäischen Klasse 1 versus Klasse 2 bezüglich Ulkusrezidiv und Patienten-Compliance. vasomed 2014; 26 (05) 270.
• 25 Reich-Schupke S. Compression therapy in obese patients. Phlebologie 2015; 44 (02) 71-76.
• 26 Partsch H, Clark M, Bassez S. et al. Measurement of lower leg compression in vivo: recommendations for the performance of measurements of interface pressure and stiffness: consensus statement. Dermatol Surg 2006; 32 (02) 224-232 discussion 233.
• 27 Kahn SR, Elman E, Rodger MA. et al. Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients. J Thromb Haemost 2003; 01 (03) 500-506.