Intervenciones para ayudar a que los pacientes se adhieran a los tratamientos de compresión para la úlcera venosa de la pierna
Información
- DOI:
- https://doi.org/10.1002/14651858.CD008378.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 06 septiembre 2013see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Heridas
- Copyright:
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- Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Carolina Weller: co‐ordinated the review process, conceived the review question, designed and developed the review, completed trial selection, data extraction and analysis, and wrote the first draft of the review. She is guarantor of the work.
Rachelle Buchbinder: supervised the performance of the review and contributed to the development and writing of the review.
Renea Johnston: contributed to the development of the review, completed trial selection, double‐checked data extraction and analysis, and contributed to writing of the review.
Contributions of Wounds Group editorial base
Nicky Cullum: edited the review, advised on methodology, interpretation and review content.
Susan O'Meara: edited the review, advised on methodology, interpretation and review content, and approved the final review prior to submission.
Sally Bell‐Syer: co‐ordinated the editorial process, advised on methodology, interpretation and content, edited the review.
Ruth Foxlee: designed the search strategy, ran the searches and edited the search methods section.
Sources of support
Internal sources
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Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Australia.
In kind support
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Cabrini Institute, St Frances Xavier Cabrini Hospital, Australia.
In kind support
External sources
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NIHR/Department of Health (England), (Cochrane Wounds Group), UK.
Declarations of interest
Carolina Weller: none known.
Renea Johnston: none known.
Rachelle Buchbinder: none known.
Acknowledgements
The authors would like to thank the peer referees of both the protocol and the review: Wounds Group editors ‐ Mieke Flour, Liz McInnes, Gill Worthy and referees ‐ Una Adderley, Anne‐Marie Bagnall, Salla Seppanen and Janet Yarrow. Thanks also to Elizabeth Royle who copy‐edited the review.
Version history
| Published | Title | Stage | Authors | Version |
| 2016 Mar 02 | Interventions for helping people adhere to compression treatments for venous leg ulceration | Review | Carolina D Weller, Rachelle Buchbinder, Renea V Johnston | |
| 2013 Sep 06 | Interventions for helping people adhere to compression treatments for venous leg ulceration | Review | Carolina D Weller, Rachelle Buchbinder, Renea V Johnston | |
| 2010 Feb 17 | Interventions for helping people adhere to compression treatments for venous leg ulceration | Protocol | Carolina Weller, Rachelle Buchbinder, Renea V Johnston | |
Differences between protocol and review
Planned meta‐analyses, subgroup and sensitivity analyses could not be performed, as we included only two trials with different interventions in the review.
Adherence to compression was a planned secondary outcome in the protocol, but we changed this to a primary outcome to reflect the review objectives better.
We reported in the protocol that we would contact relevant companies, but, as the intervention did not include compression or other devices, this was not necessary.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Humans;
PICO
Study flow diagram of the number of records identified, included and excluded, and the reasons for exclusions
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1 Leg Club versus nurse home visits, Outcome 1 Number of people healed.
Comparison 1 Leg Club versus nurse home visits, Outcome 2 Quality of life (Spitzer's quality of life index, 0‐10).
Comparison 1 Leg Club versus nurse home visits, Outcome 3 Pain at 6 months (0 to 100 scale).
Comparison 2 Lively Legs programme versus outpatient wound clinic, Outcome 1 Number of people healed.
Comparison 2 Lively Legs programme versus outpatient wound clinic, Outcome 2 Proportion with recurrence.
Comparison 2 Lively Legs programme versus outpatient wound clinic, Outcome 3 Proportion fully adherent to compression.
| Leg Club compared to nurse home visits | ||||||
| Patient or population: people with venous leg ulcers | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Leg Club | ||||||
| Number of people healed | 294 per 1000 | 456 per 1000 | RR 1.55 | 67 | ⊕⊕⊝⊝ | Not statistically different |
| Recurrence of ulcers ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Recurrence was probably measured but not reported |
| Time to healing ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Time to healing was probably measured but was not reported |
| Adverse events ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Not measured. |
| Quality of life | The mean quality of life score in the control group was 8.11 | The mean quality of life score in the intervention groups was | 52 | ⊕⊕⊝⊝ | Not statistically different | |
| Adherence to compression ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Adherence to compression was not measured |
| Pain | The mean pain score in the control group was | The mean pain in the intervention groups was | 60 | ⊕⊕⊝⊝ | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Trialists failed to conceal allocation and may have performed an unplanned interim data analysis | ||||||
| Lively Legs programme versus outpatient wound clinic | ||||||
| Patient or population: people with venous leg ulcers Comparison: outpatient wound clinic | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Lively Legs programme versus outpatient wound clinic | |||||
| Time to healing ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | Data not reported for extraction |
| Number of people healed | 45 per 100 | 55 per 100 | RR 1.24 | 184 | ⊕⊕⊝⊝ | Not statistically different |
| Adverse events ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Adverse events were not reported, unclear if measured |
| Recurrence of ulcers | 57 per 100 | 47 per 100 | RR 0.82 | 136 | ⊕⊕⊝⊝ | Not statistically different |
| Quality of life ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Not measured |
| Adherence to compression | 45 per 100 | 45 per 100 | RR 1.02 | 184 | ⊕⊕⊝⊝ | Not statistically different |
| Pain ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | Not measured |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Trialists failed to report randomisation method and allocation concealment | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Number of people healed Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 1.1 3 months | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 6 months | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 2 Quality of life (Spitzer's quality of life index, 0‐10) Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 3 Pain at 6 months (0 to 100 scale) Show forest plot | 1 | Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Number of people healed Show forest plot | 1 | Risk Ratio (M‐H, Random, 95% CI) | Totals not selected | |
| 2 Proportion with recurrence Show forest plot | 1 | Risk Ratio (M‐H, Random, 95% CI) | Totals not selected | |
| 3 Proportion fully adherent to compression Show forest plot | 1 | Risk Ratio (M‐H, Random, 95% CI) | Totals not selected | |
| 3.1 6 months | 1 | Risk Ratio (M‐H, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 3.2 12 months | 1 | Risk Ratio (M‐H, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 3.3 18 months | 1 | Risk Ratio (M‐H, Random, 95% CI) | 0.0 [0.0, 0.0] | |
