Download PDF
Phlebologie 2016; 45(04): 207-214
DOI: 10.12687/phleb2326-4-2016
Original article
Schattauer GmbH

Reality of outpatient care with medical compression stockings

Follow-up analysis of the mediven® observational study Article in several languages: English | deutsch
C. Schwahn-Schreiber
1   Institut für Gefäßmedizin, Otterndorf, Germany
,
M. Marshall
2   Institut für Gefäßmedizin, Tegernsee, Germany
,
R. Murena-Schmidt
3   Praxis für Gefäßerkrankungen, Köln, Germany
,
W. Doppel
4   medi GmbH & Co. KG, Bayreuth, Germany
,
S. Hahn
5   CYCLOMED GmbH, Hofheim, Germany
› Author Affiliations
Further Information

Publication History

Received: 07 July 2016

Accepted: 10 July 2016

Publication Date:
21 December 2017 (online)

Also available at
    Permissions and Reprints

Summary

Background The mediven observational study demonstrated that outpatient prescription of medical compression stockings (MCS) is not sufficiently guided by the medical needs of venous patients. In this follow-up analysis, we therefore evaluated the frequency of prescriptions of MCS and donning aids. Moreover, we asked whether MCS are differentially prescribed according to the patients’ CEAP classification and BMI.

Results Approximately one third of patients did not receive a prescription for a second pair of MCS at the beginning of the study and approximately one third of patients were not given a six-monthly repeat prescription. Moreover, donning aids were only rarely prescribed. These factors had an impact on compliance, since high MCS wearing frequencies were associated with both frequent MCS re-prescriptions and, at least for patients aged 61 years or above, prescription of donning aids. Prescribed MCS were mostly of light MCS quality, irrespective of the patient’s CEAP and BMI. Importantly, improvements of the CEAP classification of patients in CEAP category C3 occurred more frequently with medium and firm MCS qualities (BMI >25: 30.9 %; <25: 41.7 %) than with light MCS qualities (BMI >25: 22.4 %; <25: 13.3 %). In obese patients, constriction furrows occurred less frequently when medium or firm MCS qualities were used.

Conclusion With regard to the number and type of MCS prescriptions, there is still significant need for improvement. If required by the patients’ medical needs, medium and firm MCS qualities should be considered to a much greater extent.

Keywords

Medical compression stockings - MCS quality - reality of care - CEAP - BMI
 

  • References

  • 1 Institut für Demoskopie Allensbach. Mehr Lebensqualität, weniger Schmerzen: Nutzung und Wirksamkeit orthopädischer Hilfsmittel. Eurocom e. V 2014; 1-25.
    Search in Google Scholar
  • 2 Sippel K, Seifert B, Hafner J. Donning devices (foot slips and frames) enable elderly people with severe chronic venous insufficiency to put on compression stockings. Eur J Vasc Endovasc Surg 2015; 49 (02) 221-229.
    CrossrefPubMedSearch in Google Scholar
  • 3 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.
    CrossrefPubMedSearch in Google Scholar
  • 4 Schwahn-Schreiber C, Marshall M, MurenaSchmidt R. et al. Langzeitbeobachtung zur ambulanten Therapie phlebologischer Erkrankungen mit medizinischen Kompressionsstrümpfen in Deutschland – die mediven® Beobachtungsstudie. Phlebologie 2016; 45: 15-24.
    Thieme ConnectSearch in Google Scholar
  • 5 Wienert V, Gerlach H, Gallenkemper G. et al. Leitlinie: Medizinischer Kompressionsstrumpf (MKS). Phlebologie 2006; 35 (06) 315-320.
    Thieme ConnectSearch in Google Scholar
  • 6 Reich-Schupke S. Compression therapy in obese patients. Phlebologie 2015; 44 (02) 71-76.
    Thieme ConnectSearch in Google Scholar
  • 7 Mosti G. Relevance of stiffness of compression material on venous hemodynamics and edema. Veins and Lymphatics 2013; 02 (01) 9.
    Search in Google Scholar
  • 8 Internetportal des Deutschen Registers 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 § 23 b MPG 2014 [zitiert am: 24.03.2015]. https://drks-neu.uniklinikfreiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID= DRKS00006124
  • 9 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.
    CrossrefPubMedSearch in Google Scholar
  • 10 Weyer K, Stücker M, Pientka L. et al. Chronic venous insufficiency in a geriatric collective. Phlebologie 2015; 44 (05) 239-246.
    Thieme ConnectSearch in Google Scholar
  • 11 Benecke A, Vogel H. Übergewicht und Adipositas: Robert Koch-Institut. 2003
    PubMedSearch in Google Scholar
  • 12 Rabe E. Verordnung von Hilfsmitteln zur Kompressionstherapie. eurocom aktuell 2015; 09: 1-5.
    Search in Google Scholar
  • 13 Eurocom e.V. Hilfsmittel-Richtlinie Neuauflage. 2013; Informationen für Ärzte 2013; 1-8.
    Search in Google Scholar
  • 14 Gemeinsamer Bundesausschuss. Richtlinie des Gemeinsamen Bundesauschusses über die Verordnung von Hilfsmitteln in der vertragsärztlichen Versorgung 2015 [zit.: 29.06.2016]. https://www.g-ba.de/informationen/richtlinien/13/
  • 15 Kostas TI, Ioannou CV, Drygiannakis I. et al. Chronic venous disease progression and modification of predisposing factors. J Vasc Surg 2010; 51 (04) 900-907.
    CrossrefPubMedSearch in Google Scholar
  • 16 Rastel D. Treatment by medical compression stockings among 144 consecutive patients with non-complicated primary varicose veins: results on compliance. J Mal Vasc 2014; 39 (06) 389-393.
    CrossrefPubMedSearch in Google Scholar
  • 17 Eurocom e. V. Mehr Lebensqualität, weniger Schmerzen: Nutzung und Wirksamkeit orthopädischer Hilfsmittel. 2014
    PubMedSearch in Google Scholar
  • 18 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.
    Search in Google Scholar
  • 19 Partsch H, Winiger J, Lun B. Compression stockings reduce occupational leg swelling. Dermatol Surg 2004; 30 (05) 737-743 discussion 743..
    PubMedSearch in Google Scholar
  • 20 Blättler W, Thomä H-J, Winkler C. et al. Light medical compression stockings reduce complains while standing equally good as tight ones. Phlebologie 2016; 45 (01) 25-28.
    Thieme ConnectSearch in Google Scholar
  • 21 Partsch H, Partsch B, Braun W. Interface pressure and stiffness of ready made compression stockings: comparison of in vivo and in vitro measurements. J Vasc Surg 2006; 44 (04) 809-814.
    CrossrefPubMedSearch in Google Scholar
  • 22 Reich-Schupke S. Update on modern compression treatment. Gefässchirurgie 2013; 18 (05) 400-404.
    CrossrefSearch in Google Scholar
  • 23 Stücker M, Link K, Reich-Schupke S. Kompressionstherapie bei venösen Erkrankungen ohne Intervention. Vasomed 2014; 02: 90.
    Search in Google Scholar