The following is the Executive Summary from the whitepaper entitled "Patient-Centered Outcomes in Wound Care.".
The approach to treating a chronic or delayed healing wound has evolved greatly over the past 15 years and is best carried out by multidisciplinary teams centered on the patient's specific situation and needs.
- A wide range of approaches and products are available for treating chronic wounds, though many of them lack adequate evidence demonstrating their benefits.
- Because physicians have a variety of options for treating their patients, they often times develop an unrealistic view that all wounds can be healed as long as patients receive enough of the proper therapy for a sufficient amount of time. However, this is not always the case.
- The range of therapeutic options, while appealing to physicians who want to heal their patients' wounds, come with a variety of caveats for patients, including pain, discomfort, inconvenience, expense, and burden to their caregivers.
Patients with chronic wounds do not feel engaged in the decisions made regarding their care. As a result, patient concerns about the care of their wounds are often not aligned with the concerns of their health care providers.
- Patient-centered outcomes research benefits all constituencies:
- It helps patients and their caregivers communicate and make better-informed health care decisions, allowing their voices to be heard when assessing the value of health care options.
- It helps payers ensure that health care dollars are being spent in ways that maximize benefits for patients.
- It helps treatment developers by providing important clinically meaningful endpoints for clinical trials.
- Patients must become an integral part of the wound healing enterprise by:
- Involving them during the education of physicians on wound care.
- Developing a system in which patients can provide input to health care professionals interested in wound care and clinical conditions associated with non-healing wounds.
- Creating mentorship-style relationships between health care professionals-in-training and patients. These relationships would empower patients and produce a new generation of health care professionals who encourage, rather than discount, patient input into the choice of care.
- Creating patient networks that would play an active role in providing patient support, educating health care professionals, and increasing public awareness about the causes and treatment of chronic wounds.
Patients, caregivers, and clinicians alike strongly believe that wound healing should be managed by teams of health care providers who would work together at wound care clinics to provide high quality care (centers of excellence). The staff at these wound care clinics would be thoroughly versed in both the medical and non-medical aspects of chronic wounds.
- These centers of excellence would have a mission to provide optimal, individualized care, and to inform the broader medical community about the need to refer their patients with non-healing wounds to specialized clinics when no improvement is noted after initial appropriate care.
- Centers of excellence would develop therapeutic approaches that prioritize the patient's needs and desires. This would require training health care professionals at these centers to engage in clear and honest dialogue with patients and their caregivers about available treatment options and the evidence to support those options.
Limited research funding on wound care and wound healing translates to a poor understanding of disease pathology and a limited ability to predict which patients respond or do not respond to different treatment modalities, detracting from the quality of patient care.
All clinical studies on wound healing technologies, methods, and products, regardless of the funding source, should include validated patient-centered outcome measures.
- Validated measures for patient-centered outcomes are needed for research studies.
Criteria must be identified and used as a basis for assessing wound care centers and the credentials of physicians who work as specialists in wound healing and as deliverers of evidence-based, high-quality wound care.