Concordance treatment continuum: A proposed clinical outcome to boost concordance with compression therapy

Research by MacGregor (2013)and shows that 1–3 % of the population experience chronic venous insufficiency (CVI). Among these individuals, 60–80 % develop venous leg ulcers (VLU), according to Nelson and Adderley (2016). However, patient adherence to compression therapy (CT)—the gold standard treatment for VLUs—remains low at 39.9 %, even for those whose ulcers have healed. This lack of concordance heightens the risk of ulcer recurrence (Erickson et al., 1995; Finlayson et al., 2014; Kapp et al., 2013), presenting a significant and costly challenge for healthcare systems (Smith & McGuiness, 2010). Compression therapy works by enhancing venous return and reducing both venous pressure and stasis.

Two Delphi studies conducted revealed a combined 105 overall factors. Whilst clinicians and patients identified different factors that influence long term concordance, there was consensus around factors that contribute to comfort, motivation, access to health care, and clinician attributes. Further research is needed to combine these elements into a concise clinical guideline, a concordance treatment continuum, to assist both the clinician and patient to achieve long term concordance with CT, to improve clinical outcomes of VLU reoccurrence.