Clinical outcomes and cost-effectiveness of an externally applied electroceutical device in managing venous leg ulcers in clinical practice in the UK

Guest, Julian F.; Ayoub, Nadia; Greaves, Tanya

doi:10.12968/jowc.2015.24.12.572

Cited by 17 publications

(19 citation statements)

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“…The natural history of VLUs is of a continuous cycle of healing and breakdown over decades: VLUs are typically painful and heal slowly, resulting in an impaired quality of life (QoL), social isolation and reduced work productivity . Treatment of this major health problem results in a considerable cost to the National Health Service (NHS): each ulcer costs up to £1981 per year; estimated total healthcare costs are between £198 million and £400 million per year, with 65% of these costs occurring in the community …”

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confidence: 99%

Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial

et al. 2018

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SummaryBackgroundVenous leg ulcers (VLUs) are typically painful and heal slowly. Compression therapy offers high healing rates; however, improvements are not usually sustained. Exercise is a low‐cost, low‐risk and effective strategy for improving physical and mental health. Little is known about the feasibility and efficacy of supervised exercise training used in combination with compression therapy patients with VLUs.ObjectivesTo assess the feasibility of a 12‐week supervised exercise programme as an adjunct therapy to compression in patients with VLUs.MethodsThis was a two‐centre, two‐arm, parallel‐group, randomized feasibility trial. Thirty‐nine patients with venous ulcers were recruited and randomized 1 : 1 either to exercise (three sessions weekly) plus compression therapy or compression only. Progress/success criteria included exercise attendance rate, loss to follow‐up and patient preference. Baseline assessments were repeated at 12 weeks, 6 months and 1 year, with healing rate and time, ulcer recurrence and infection incidents documented. Intervention and healthcare utilization costs were calculated. Qualitative data were collected to assess participants’ experiences.ResultsSeventy‐two per cent of the exercise group participants attended all scheduled exercise sessions. No serious adverse events and only two exercise‐related adverse events (both increased ulcer discharge) were reported. Loss to follow‐up was 5%. At 12 months, median ulcer healing time was lower in the exercise group (13 vs. 34·7 weeks). Mean National Health Service costs were £813·27 for the exercise and £2298·57 for the control group.ConclusionsThe feasibility and acceptability of both the supervised exercise programme in conjunction with compression therapy and the study procedures is supported.

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confidence: 99%

Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial

et al. 2018

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“…In Guest et al (2015b)'s study, when applied to VLUs with a mean age of one year, Accel-Heal enabled full wound closure within 2.5 months; when applied to VLUs with a mean age of 6.1 years, it was linked to a 42% reduction in wound size. All patients experienced improved clinical outcomes including a reduction in pain and exudate levels.…”

Section: Electroceutical Treatmentmentioning

confidence: 99%

Section: Economic Benefits and Implications For Nursing Practicementioning

confidence: 99%

“…Several studies have demonstrated the costeffectiveness of using electric stimulation for the management of chronic wounds (Clegg and Guest 2007, Taylor et al 2011, Guest et al 2015b. Guest et al (2015b) demonstrated that using an electroceutical treatment for the management of VLUs was a dominant treatment -that is, it resulted in improved outcomes for less cost. In the 12 months after the electroceutical treatment, compared with the same period before the treatment, there was a 12% improvement in health of 0.09 quality-adjusted life years (p<0.01), a 34% reduction in required nurse visits per patient from a mean of 50.7 to 33.3, and a 26% reduction in the number of dressings.…”

Section: Economic Benefits and Implications For Nursing Practicementioning

confidence: 99%

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Using electroceutical treatment to reduce symptoms and improve healing in chronic wounds

Ovens¹

2017

Primary Health Care

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Chronic inflammation in a wound is often associated with infection and biofilm, which are linked to raised matrix metalloproteinases (elevated protease activity) and reduced cell production along with growth hormones in the wound bed. This causes persistent challenges to healthcare professionals and increases the costs of wound management; the related symptoms also affect the quality of life (QoL) of patients living with wounds that are hard to heal. Electrical energy known as the 'current of injury' is required to assist in tissue repair. It allows different cell types, such as white blood cells, growth factors, enzymes and fibroblasts, into the wound to allow for stimulation of cell proliferation and collagen synthesis. In chronic wounds, the current of injury becomes disrupted due to biofilms, infection and unhealthy tissue in the wound bed. This prevents the wound from going through normal physiological healing. Use of electrical stimulation and electroceutical treatment effectively restores the current of injury, expediting normal healing and reducing chronic inflammation, biofilms, infection and associated symptoms, such as pain and high exudate. Clinical outcomes and QoL are improved and there are also economic benefits.

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“…Recent studies have highlighted a new use of electrical stimulation called "electroceutical therapy" that uses electrical stimulation to influence and modify the functions of the body that allow the treatment of various pathologies Through autogenously production of neurotransmitters [13].…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation with “Software Controlled Short Tension Impulses Therapy” (So.Co.Short) for Lumbar and Cervical Chronic Radiculopathy

Saggini¹,

Carmignano²,

Supplizi³

et al. 2017

J Nov Physiother

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Background: Recent studies have highlighted a new use of electrical stimulation called electroceutical therapy that uses electrical stimulation similar to frequency modulated electromagnetic neural stimulation (FREMS) that influence and modify the functions of the body. A pilot study was designed aimed to evaluate the efficacy of "Software Controlled Short Tension Impulses Therapy" (So.Co.Short) in subjects with lumbar and cervical radiculopathy in chronic phase treated with two different protocol one daily or and the other every other day. Furthermore, the second endpoint is monitor analgesic intake for 2 month after the end of protocol. Materials and Methods:60 patients with chronic cervical radiculopathy were included, aged between 31 and 80 years and 70 subjects with chronic lumbar radiculopathy aged between 28 and 80 years. Patients underwent a session, using a newly-developed biomedical device that allows the application of software-controlled electric impulses of variable tension, frequency and duration "Software Controlled Short Tension Impulses Therapy"-(So co.Short) for 10 sessions with two modalities of application: daily or every other day. At the beginning (T0) and the end (T1) of the treatment all patients performed Visual Analogic Scale (VAS), Neck Disability Index (NDI) or Oswestry Disability Index (ODI). A drug diary was kept by each subject to monitor analgesic intake at T0 (before 2 weeks at beginning of study) and 1 month after the end of protocols. Results:Results confirm effectiveness for pain relief and reduction of analgesic intake. Conclusion:In conclusion, the findings of this study confirm that So.Co.Short is safe and leads to pain relief and improvement of healing in lumbar and cervical chronic radiculopathy. Probably the best application is on every other days, because stimulating the production of growth factors and triggering the relief of pain, must leave enough time for the molecules produced to act on the inflammatory process.

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Clinical outcomes and cost-effectiveness of an externally applied electroceutical device in managing venous leg ulcers in clinical practice in the UK

Abstract: Within the study's limitations, use of the EAE device potentially affords the NHS a cost-effective treatment for managing VLUs when compared with patients remaining on their previous care plan.

Cited by 17 publications

References 17 publications

Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial

Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial

Using electroceutical treatment to reduce symptoms and improve healing in chronic wounds

Rehabilitation with “Software Controlled Short Tension Impulses Therapy” (So.Co.Short) for Lumbar and Cervical Chronic Radiculopathy

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