A qualitative study of barriers and facilitators to compression stocking use in patients with chronic venous insufficiency

IntroductionCompression stocking therapy is the gold standard of treatment for conditions associated with lower limb venous dysfunction. The benefits in symptom relief and preventing disease progression are well documented. Despite this, adherence to compression stocking therapy is poor. This project aimed to identify factors affecting compression stocking adherence in Aotearoa New Zealand through qualitative evaluation of interviews of patients with chronic venous insufficiency.MethodsIn this mixed-methods study, 25 participants were recruited, and semi-structured interviews were carried out until thematic saturation was reached. All participants also took part in surveys recording characteristics and Quality of Life questionnaires. Common interview themes were summarized and quality of life scores were compared between respondents.FindingsInterview respondents were a median of 64 years old, and were prescribed compression therapy a median of 8 years prior. The cohort spent a median of 8 h a day standing. Qualitative interviews identified three main themes influencing compression stocking use: physical factors, psychological factors and external factors. Subthemes included the influence of age and sex on participant perceptions of the stockings' appearance, and how comorbidities contribute to donning difficulty.ConclusionUnderstanding factors influencing patient adherence can enable clinicians to provide a multidimensional approach, mitigating barriers and emphasizing facilitators for the individual patient to improve adherence.