Leg ulceration in drug users: development of a multidisciplinary care pathway

Individuals with a history of intravenous (IV) drug abuse can develop a degree of venous insufficiency either through the damage of veins from the injection, or the formation of deep vein thrombosis (DVT), a complication of IV drug abuse. Long-term venous insufficiency can result in painful lower limb ulceration that can negatively effect quality of life. This patient group can be challenging to manage due to problems with engagement and concordance; patients often have chaotic lifestyles with a range of health needs. A care pathway was developed to promote healing through the implementation of the well-being model and utilisation of the multidisciplinary team.

[1]  D. De Angelis,et al.  An evidence synthesis approach to estimating Hepatitis C Prevalence in England and Wales , 2009, Statistical methods in medical research.

[2]  P. Vowden,et al.  The prevalence, management and outcome for patients with lower limb ulceration identified in a wound care survey within one English health care district. , 2009, Journal of tissue viability.

[3]  A. Roden The challenge of managing wounds in the injecting drug- dependent patient , 2009 .

[4]  I. Anderson Compression bandaging in patients with venous insufficiency. , 2008, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[5]  T. Bennett,et al.  Identifying and preventing health problems among young drug‐misusing offenders , 2008 .

[6]  G. Hay,et al.  National and regional estimates of the prevalence of opiate use and/or crack cocaine use 2006/07: a summary of key findings. , 2008 .

[7]  T. Rhodes,et al.  Shooting up: infections among injecting drug users in the United Kingdom 2006. An update: October 2007. , 2007 .

[8]  C. Wheatley Collaborative working to improve leg ulcer outcomes for injecting drug users. , 2007, British journal of nursing.

[9]  Julio S. G. Montaner,et al.  Prevalence and correlates of cervical cancer screening among injection drug users. , 2006, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[10]  J. stephen-Haynes An overview of compression therapy in leg ulceration. , 2006, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[11]  M. Gossop Treating drug misuse problems : evidence of effectiveness , 2006 .

[12]  B. Pieper,et al.  Injection drug use and wound care. , 2005, The Nursing clinics of North America.

[13]  M. Bellis,et al.  Injecting drug use in Brighton, Liverpool, and London: best estimates of prevalence and coverage of public health indicators , 2004, Journal of Epidemiology and Community Health.

[14]  M. Battegay,et al.  Staphylococcus aureus Infections in Injection Drug Users: Risk Factors and Prevention Strategies , 2004, Infection.

[15]  J. Neale Measuring the health of Scottish drug users. , 2004, Health & social care in the community.

[16]  E. A. Nelson,et al.  Prevalence of Lower-Limb Ulceration: A Systematic Review of Prevalence Studies , 2003, Advances in skin & wound care.

[17]  A. C. van der Wal,et al.  Causes, investigation and treatment of leg ulceration , 2003, The British journal of dermatology.

[18]  P. Meier,et al.  Estimates of the Scale of the Problem. In: Hidden Harm - Responding to the needs of children of problem drug users. , 2003 .

[19]  S. Closs,et al.  The prevalence of leg ulceration: a review of the literature , 2003 .

[20]  P. Nicolson,et al.  Injecting drug use: implications for skin and wound management. , 2002, British journal of nursing.

[21]  Duncan Stewart,et al.  A prospective study of mortality among drug misusers during a 4-year period after seeking treatment. , 2002, Addiction.

[22]  T. Templin,et al.  Chronic venous insufficiency in persons with a history of injection drug use. , 2001, Research in nursing & health.

[23]  E. A. Nelson,et al.  Compression for venous leg ulcers. , 2001, The Cochrane database of systematic reviews.

[24]  E. A. Nelson Understanding compression therapy. , 1998, Journal of wound care.

[25]  D Bergqvist,et al.  Chronic leg ulcers: an underestimated problem in primary health care among elderly patients. , 1991, Journal of epidemiology and community health.

[26]  S. Abston,et al.  The silent epidemic. , 1972, JAMA.