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Adherence to Compression Stockings for Venous Leg Ulcer Prevention: A Pilot Randomised Controlled Trial and Health Economic Analysis, Evaluating a New Multidimensional Tool ( PAMCAI )

Year: 2025
Type: article
Abstract: Venous leg ulcer recurrence can be prevented with daily compression stocking wear; however, stocking effectiveness is often hindered by poor patient adherence. The 'Personalised and Multi-dimensional Compression Assessment and Intervention' (PAMCAI) is a multidimensional decision aid, delivered by clinicians via an iPad application, designed to improve adherence. This study piloted the methodology and feasibility of PAMCAI's efficacy and cost-effectiveness for evaluation in a larger randomised controlled trial (RCT). Using a two-arm, single-blinded pilot RCT with cost-utility analysis, PAMCAI was compared with usual care in a tertiary hospital occupational therapy outpatient clinic. The primary outcome was adherence to wearing compression stockings, measured on a 4-point scale. Twenty participants were randomised to receive PAMCAI (n = 10) or usual care (n = 10). Recruitment and pilot methodology appear feasible for use in a larger study. Compression stocking adherence was greater with PAMCAI compared to usual care (p = 0.002) and PAMCAI is likely cost-effective, with an incremental cost-effectiveness ratio of $3379.36 per quality-adjusted life year (QALY) gained. Resolution of identified barriers to stocking adherence was positively associated with improvements in patient adherence. These findings support further investigation of PAMCAI in a larger RCT and its potential to improve patient adherence and the cost-effectiveness of compression therapy for venous leg ulcer prevention.
DOI: 10.1111/iwj.70244
Language: English
Subfield: Surgery
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,580
OpenAlex ID: W4409453899
FWCI: 3.57
Cites: 55
Cited by: 4
Related to: 10