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Management and outcomes among patients with hard-to-heal ulcers in Sweden : a national mapping of data from medical records, focusing on diagnoses, ulcer healing, ulcer treatment time, pain and prescription of analgesics and antibiotics

Öien, Rut Frank ; Roxenius, Jenny ; Boström, Maria and Wickström, Hanna Linnea LU (2024) In BMJ Open 14(8).
Abstract

Objective To investigate whether patients with hard-to-heal ulcers in Sweden were treated according to an aetiological diagnosis and to explore ulcer healing, treatment time, ulcer-related pain and the prescription of analgesics and antibiotics. Design A national mapping of data from the patients’ medical records, between April 2021 and March 2023. Setting Data from medical records for patients with hard-to-heal ulcers from a randomised clustered sample of two units per level of care and region. Participants Patients with hard-to-heal ulcers treated in primary, community and specialist care, public or private, within units covering all 21 regions in Sweden. Outcome measures Descriptive analysis of data from the patients’ medical... (More)

Objective To investigate whether patients with hard-to-heal ulcers in Sweden were treated according to an aetiological diagnosis and to explore ulcer healing, treatment time, ulcer-related pain and the prescription of analgesics and antibiotics. Design A national mapping of data from the patients’ medical records, between April 2021 and March 2023. Setting Data from medical records for patients with hard-to-heal ulcers from a randomised clustered sample of two units per level of care and region. Participants Patients with hard-to-heal ulcers treated in primary, community and specialist care, public or private, within units covering all 21 regions in Sweden. Outcome measures Descriptive analysis of data from the patients’ medical records. Results A total of 2470 patients from 168 units were included, of which 39% were treated in primary care, 24% in community care and 37% in specialist care. A total of 49% of patients were treated without an aetiological diagnosis. Healing occurred in 37% of patients and ulcer-related pain was experienced by 1224 patients (50%). Antibiotics were given to 56% of the patients. Amputation occurred in 5% and 11% were deceased. Conclusion Only 51% of patients with hard-to-heal ulcers had a documented aetiological ulcer diagnosis, which means that approximately 20 000 patients in Sweden might receive suboptimal treatment. Future research needs to explore why so many patients are undiagnosed and how to improve diagnosis, which could lead to faster healing and shorter treatment times.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ Open
volume
14
issue
8
article number
e087894
publisher
BMJ Publishing Group
external identifiers
  • scopus:85202007708
  • pmid:39174055
ISSN
2044-6055
DOI
10.1136/bmjopen-2024-087894
language
English
LU publication?
yes
id
91883a17-9dda-40c1-a985-7272f8f3b135
date added to LUP
2024-10-28 13:11:36
date last changed
2025-07-08 11:20:36
@article{91883a17-9dda-40c1-a985-7272f8f3b135,
  abstract     = {{<p>Objective To investigate whether patients with hard-to-heal ulcers in Sweden were treated according to an aetiological diagnosis and to explore ulcer healing, treatment time, ulcer-related pain and the prescription of analgesics and antibiotics. Design A national mapping of data from the patients’ medical records, between April 2021 and March 2023. Setting Data from medical records for patients with hard-to-heal ulcers from a randomised clustered sample of two units per level of care and region. Participants Patients with hard-to-heal ulcers treated in primary, community and specialist care, public or private, within units covering all 21 regions in Sweden. Outcome measures Descriptive analysis of data from the patients’ medical records. Results A total of 2470 patients from 168 units were included, of which 39% were treated in primary care, 24% in community care and 37% in specialist care. A total of 49% of patients were treated without an aetiological diagnosis. Healing occurred in 37% of patients and ulcer-related pain was experienced by 1224 patients (50%). Antibiotics were given to 56% of the patients. Amputation occurred in 5% and 11% were deceased. Conclusion Only 51% of patients with hard-to-heal ulcers had a documented aetiological ulcer diagnosis, which means that approximately 20 000 patients in Sweden might receive suboptimal treatment. Future research needs to explore why so many patients are undiagnosed and how to improve diagnosis, which could lead to faster healing and shorter treatment times.</p>}},
  author       = {{Öien, Rut Frank and Roxenius, Jenny and Boström, Maria and Wickström, Hanna Linnea}},
  issn         = {{2044-6055}},
  language     = {{eng}},
  number       = {{8}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Management and outcomes among patients with hard-to-heal ulcers in Sweden : a national mapping of data from medical records, focusing on diagnoses, ulcer healing, ulcer treatment time, pain and prescription of analgesics and antibiotics}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2024-087894}},
  doi          = {{10.1136/bmjopen-2024-087894}},
  volume       = {{14}},
  year         = {{2024}},
}