Supporting Patients on Their Wound Care Journey

Welcome back to Podiatry Today Podcasts, where we bring you the latest in foot and ankle medicine and surgery from leaders in the field. Today we welcome Dr. Windy Cole as our guest as part of a two episode series on the chronic wound care patient experience. Dr. Cole is the Director of Wound Care Research at the Kent State University College of Podiatric Medicine, and the Global Medical Affairs Director for Natrox Wound Care. In this first episode we will touch on how clinicians can support the patient journey in wound care. Let's get started.

So it seems that there's a push within the wound management community that's supporting the collection of patient reported outcomes measures. Can you give us some background on this?

Windy Cole, DPM:

Absolutely. Patient reported outcome measures, otherwise noted as PROMs, and patient reported experience measures, PREMs can give rise to very valuable feedback about our patient's journey.

Through surveys and interviews of the patients we can get information that's useful for all aspects of their care, including their overall satisfaction with treatments, their symptoms and severity of those symptoms throughout their care, quality of life, mental health and other social interactions. And by analyzing this data healthcare professionals and healthcare organizations can better understand if the services that we're providing, and the procedures that patients are undergoing, are contributing to the health status of a certain patient population. Additionally, this information can be used to determine treatment algorithms and drive policy, and impacts healthcare service offerings, and really influence the quality performance measures and patient outcomes.

Jennifer Spector, DPM:

So what have clinicians learned from patients about living with chronic wounds?

Windy Cole, DPM:

Quite honestly, a lot. Non-healing wounds also take a significant toll on really all aspects of our patient's lives. Patient feedback confirms that living with a chronic wound is demanding and can be very restrictive. Daily routines become dictated by clinical appointments, tests, bandage changes, and this all can take many, many hours over weeks of therapy.

The indirect consequences of living with chronic wounds are pain, exudate and odor, and these often contribute to social isolation of our patients. Many chronic wound patients will limit social interactions. I've had many patients tell me that they no longer go to church, or out to restaurants, or to family functions because of concerns about wound drainage and odor. The social isolation can lead to depression, anxiety, and even sleep disturbances, which will all negatively impact their quality of life.

Additionally, many patients tell us they're unable to participate in the physical activities that they love, like walking or swimming or biking, and these are the activities that really help them cope with stress and depression and pain. So as you can see this can become a real vicious cycle and negatively affect really all aspects of their life.

Jennifer Spector, DPM:

How do you think PROM and PREM feedback will change chronic wound management?

Windy Cole, DPM:

Well, I always say that wound management should not be a one size fits all specialty, and this kind of tells us that that is true. Our patients are really complex and we should practice within a patient-centered care framework, and I think we need to be more cognizant of that as healthcare providers and wound care clinicians.

In this sort of care management algorithm patients' voices will merge with the provider's knowledge and expertise to hopefully produce shared decision-making on treatment options and care plans. And by sharing the best available evidence with our patients they can then consider the options to achieve their specific goals based on their personal preferences. So how many times do providers ask patients what their biggest concerns or their treatment goals are? Probably not as often as we should. Nowadays, patients prefer to participate in healthcare decisions, and as clinicians it's our job to break down the best evidence and options, weighing the risk and benefits for our patients. And in doing so we can support this patient-centered outcomes and care plans and improve overall care satisfaction. And really there's a potential to reduce healthcare expenditures too.

Jennifer Spector, DPM:

The definition of a patient outcome is certainly much more than if a wound closes. Given the length of time these patients are typically under care the outcomes measures Dr. Cole shared are vital pieces of information that can make us better clinicians and improve all aspects of care. We'd like to thank Dr. Cole for sharing these thoughts with us today, and also thank you the audience for joining us. We will follow up with Dr. Cole soon and learn a little more about one particular aspect of the wound patient journey, and that's pain management.

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