Health-related quality of life of patients with hard-to-heal ulcers measured with the 15D instrument: a prospective study

Abstract

Objective: The aim of the study was to investigate the health-related quality of life (HRQoL) of patients with hard-to-heal ulcers in a prospective study setting, and further to investigate the factors associated with HRQoL. Method: Patients with hard-to-heal ulcers referred to the Wound Centre of Tampere University Hospital, Finland, completed the 15D HRQoL questionnaire. The 15D scores were compared to an ageand sex-matched general population cohort and to patients with chronic pain and cancer. The baseline background and clinical data of patients with hard-to-heal ulcers were obtained from patient records and the Registry of Chronic Wounds at the Wound Centre, and follow-up information via questionnaires sent to the study participants six months after the first visit. Factors associated with baseline HRQoL and HRQoL changes during the follow-up were analysed. Results: A total of 142 patients with hard-to-heal ulcers were included in the study. The mean 15D score of the patients with hardto-heal ulcers was lower than that of the general population cohort and patients with breast and prostate cancer, but higher than that of patients with chronic pain. Patients with an arterial or mixed ulcer had the lowest 15D scores, and negative correlations were detected between 15D scores and age, number of comorbidities and use of pain medication. During follow-up, the 15D score improved significantly in 43% of the patients, but ulcer healing was not associated with increasing 15D scores. Conclusion: In this study, the HRQoL of patients with hard-to-heal ulcers was substantially impaired. In addition to ulcer aetiology, age and comorbidities were associated with HRQoL highlighting the importance of multidisciplinary care and this most likely explains the lack of correlation between ulcer healing and 15D score change during follow-up. Declaration of interest: This study was financially supported by the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, Finland (9X061, 9AA082) and research funding was also provided by the Support Foundation of Tampere University Hospital (MK326), Tampere University, Faculty of Medicine and Health Technology, Finland, and the Finnish Dermatological Society. HS is the developer of the 15D and obtains royalties from its electronic versions. The other authors have no conflicts of interest to declare.