Factors affecting patients’ self-management in chronic venous disorders: a single-center study

BACKGROUND The conservative treatment of chronic venous disorders (CVDs) includes pharmacotherapy, compression therapy, physiotherapy, and changes in lifestyle. These methods are available without prescription and not reimbursed by Polish National Health Service. Adherence to therapy is affected by poorly characterized patient-related factors. OBJECTIVE The aim of the study was to perform an assessment of factors that affect the usage and resignation from conservative methods in CVD self-management. METHODS A structured interview concerning self-management was carried out with 407 consecutive CVD patients of mean age 64.4 years (range: 23-87 years). All the patients had recently undergone Doppler examination and were classified in accordance with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification. RESULTS Pharmacotherapy was the most frequently (85.0% of respondents) used method in CVD self-management. Obese (odds ratio [OR] =1.75 [95% confidence interval {CI} 0.99-3.05]) and subjects with longer duration of the disease (OR =1.74 [95% CI 1.16-2.62]) were more likely to use venoactive drugs, while females used ointments commonly containing heparin (OR =1.82 [95% CI 1.08-3.03]). Compression therapy was perceived by respondents as the most difficult method in self-management (OR =2.50 [95% CI 1.61-3.88]) and was also recognized as the most effective method of treatment (OR =13.9 [95% CI 7.35-26.4]). Longer duration of CVD (≥15 years) increased (OR =1.78 [95% CI 1.16-2.71]) while obesity decreased (OR =0.38 [95% CI 0.20-0.72]) the utilization of compression therapy. Females were more likely to adhere to lifestyle changes than males (OR =1.68 [95% CI 0.97-2.90]). Physiotherapy was rarely used by the patients. CONCLUSION Obesity and longer duration of CVDs increase the use of venoactive drugs. Subjects with longer duration of the disease and without obesity are more likely to utilize compression therapy, the method considered to be the most effective but difficult in CVD self-management. Females are more prone to lifestyle changes and the use of heparin-containing ointments. There is an unmet need for health promotion regarding available CVD treatment methods and proper weight control measures to support CVD self-management.