Volume 6 ; Issue 1 ; in Month : Jan-Jun (2022) Article No : 135
Papageorgiou V, Ntourakis D, Ravelojaona M

Abstract

Introduction: In 2006 the French National Authority for Health (HAS) published guidelines for the management of venous leg ulcers (VLU), a common disease with a significant financial burden affecting the public health. We carried out an observational study regarding the implementation of these recommendations by general practitioners (GPs) in Alsace. Methodology: A questionnaire of 20 questions was sent to 1295 GPs in Alsace. Univariate and bivariate statistical analysis was performed. Results: One hundred fifty-three (153) questionnaires were analysed. The majority (76%) of GPs were not aware of the HAS guidelines. The ankle-brachial index (ABI) was prescribed/performed by only 20% of practitioners and the lower limb venous Doppler ultrasound was prescribed by 52%. Compression treatment was prescribed systematically by 83% of practitioners. Microbiology investigations and antibiotic treatment were found to be in accordance with the guidelines. Multiple layer bandages were not adopted by the practitioners as a compression treatment (prescribed only by 25%). Bivariate analysis showed that GPs who performed ABI measurement would also prescribe multiple layer bandages. Previous experience in managing patients with VLU, but not the knowledge of the HAS guidelines, seems to affect the implementation of these two recommendations. Conclusion: This study, first inventory conducted in Alsace, has shown that the ABI measurement and the compression by multiple layer bandages are two recommendations that are only minimally being followed by the practitioners. A supplementary qualitative study of the GPs could be conducted to define the limiting factors.

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