Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management

David Russell, Leanne Atkin, April Betts, Caroline Dowsett, Francis Fatoye, Sarah Gardner, Julie Green, Chris Manu, Tracey Mackenzie, Helena Meally, Louise Mitchell, Julie Mullings, Issac Odeyemi, Andrew Sharpe, Gillian Yeowell, Nancy Devlin

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:
Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing.

METHOD:
A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts.

RESULTS:
In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus.

CONCLUSION:
This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.
LanguageEnglish
Pages156-165
Number of pages10
JournalJournal of wound care
Volume27
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018

Fingerprint

Bandages
Cost of Illness
Wounds and Injuries
Matrix Metalloproteinases
Varicose Ulcer
Leg Ulcer
Diabetic Foot
Administrative Personnel
Wound Healing
Caregivers
Health Services
Nurses
Economics
Quality of Life
Costs and Cost Analysis

Cite this

Russell, D., Atkin, L., Betts, A., Dowsett, C., Fatoye, F., Gardner, S., ... Devlin, N. (2018). Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management. Journal of wound care, 27(3), 156-165. https://doi.org/10.12968/jowc.2018.27.3.156
Russell, David ; Atkin, Leanne ; Betts, April ; Dowsett, Caroline ; Fatoye, Francis ; Gardner, Sarah ; Green, Julie ; Manu, Chris ; Mackenzie, Tracey ; Meally, Helena ; Mitchell, Louise ; Mullings, Julie ; Odeyemi, Issac ; Sharpe, Andrew ; Yeowell, Gillian ; Devlin, Nancy. / Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management. In: Journal of wound care. 2018 ; Vol. 27, No. 3. pp. 156-165.
@article{8c6c953e7da046cdbd5dabac96e2fa42,
title = "Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management",
abstract = "OBJECTIVE:Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing.METHOD:A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts.RESULTS:In the first round, 38/47 statements reached or exceeded the consensus threshold of 80{\%} and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80{\%} consensus.CONCLUSION:This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.",
keywords = "Delphi method, diabetes, Wound care, leg ulceration",
author = "David Russell and Leanne Atkin and April Betts and Caroline Dowsett and Francis Fatoye and Sarah Gardner and Julie Green and Chris Manu and Tracey Mackenzie and Helena Meally and Louise Mitchell and Julie Mullings and Issac Odeyemi and Andrew Sharpe and Gillian Yeowell and Nancy Devlin",
year = "2018",
month = "3",
day = "1",
doi = "10.12968/jowc.2018.27.3.156",
language = "English",
volume = "27",
pages = "156--165",
journal = "Journal of wound care",
issn = "0969-0700",
publisher = "MA Healthcare Ltd",
number = "3",

}

Russell, D, Atkin, L, Betts, A, Dowsett, C, Fatoye, F, Gardner, S, Green, J, Manu, C, Mackenzie, T, Meally, H, Mitchell, L, Mullings, J, Odeyemi, I, Sharpe, A, Yeowell, G & Devlin, N 2018, 'Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management', Journal of wound care, vol. 27, no. 3, pp. 156-165. https://doi.org/10.12968/jowc.2018.27.3.156

Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management. / Russell, David ; Atkin, Leanne; Betts, April; Dowsett, Caroline; Fatoye, Francis; Gardner, Sarah; Green, Julie; Manu, Chris; Mackenzie, Tracey; Meally, Helena; Mitchell, Louise ; Mullings, Julie; Odeyemi, Issac; Sharpe, Andrew; Yeowell, Gillian; Devlin, Nancy.

In: Journal of wound care, Vol. 27, No. 3, 01.03.2018, p. 156-165.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management

AU - Russell, David

AU - Atkin, Leanne

AU - Betts, April

AU - Dowsett, Caroline

AU - Fatoye, Francis

AU - Gardner, Sarah

AU - Green, Julie

AU - Manu, Chris

AU - Mackenzie, Tracey

AU - Meally, Helena

AU - Mitchell, Louise

AU - Mullings, Julie

AU - Odeyemi, Issac

AU - Sharpe, Andrew

AU - Yeowell, Gillian

AU - Devlin, Nancy

PY - 2018/3/1

Y1 - 2018/3/1

N2 - OBJECTIVE:Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing.METHOD:A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts.RESULTS:In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus.CONCLUSION:This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.

AB - OBJECTIVE:Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing.METHOD:A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts.RESULTS:In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus.CONCLUSION:This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.

KW - Delphi method

KW - diabetes

KW - Wound care

KW - leg ulceration

UR - http://www.scopus.com/inward/record.url?scp=85043382184&partnerID=8YFLogxK

U2 - 10.12968/jowc.2018.27.3.156

DO - 10.12968/jowc.2018.27.3.156

M3 - Article

VL - 27

SP - 156

EP - 165

JO - Journal of wound care

T2 - Journal of wound care

JF - Journal of wound care

SN - 0969-0700

IS - 3

ER -