Management of chronic venous disease in general practice: a cross-sectional study of first line care in Belgium

Background: The aim of this observational study was to examine how general practitioners (GP) in Belgium treat patients with chronic venous disease (CVD). Methods: This cross-sectional study was carried out in Belgium by GPs who recruited 15 consecutive patients who were consulting them and suffered from CVD. By following a standardized questionnaire, they collected information on patient characteristics, risk factors, signs and symptoms, and how they were being managed. Results: Two hundred fifty-three GPs recruited 3055 patients, who were predominantly female (75.6%), with a mean age of 62.7 (SD=14.6). 20.1% of the population suffered from CVD without clinical signs (C0s). 8.7% of the population had advanced disease (C5-C6). Most common symptoms were respectively "heavy legs" (43.7%), "swollen feeling" (28%) and "pain" (24.1%). The primary care physicians decided 95.3% of patients needed therapy of some sort. The most used treatment option used in 83.3% of subjects was the use of venoactive medication. Lifestyle advice was recommended in 64.5% of patients and recommendations regarding compression stockings were given in 46.9% of patients. Referral to a specialist was warranted for 24.5% of the population. Patients with a lower C Classification were more often treated conservatively compared to those with a higher C Classification. Conclusions: Most patients were treated conservatively, which includes lifestyle changes, medication, and compression. Only one in four patients is referred to a vascular specialist and this referral is significantly positively correlated with the C Classification. (Cite this article as: Jure J, Vuylsteke ME. Management of chronic venous disease in general practice: a cross-sectional study of first line care in Belgium. Int Angiol 2022;41:232-9. DOI: 10.23736/S0392-9590.22.04774-5)