Quality of life in wound management
Our recent publication titled ‘Clinical performance and quality of life impact of an absorbent bacteria-binding foam dressing’ recognised the importance of the psychosocial effects of living with a wound (Seckam et al, 2021). These impairments can affect various areas of life, leading, for example to pain, social isolation and psychological consequences (Topp et al, 2021; Guo and DiPietro, 2010), thus affecting patients' wellbeing and quality of life (QoL).
It is therefore important to consider patient QoL in wound management. Interpretation of QoL scores are important, placing the patient at the centre of their treatment regimen. Subsequently, this allows them to reflect on their treatment regimen and consider future implications (Topp et al, 2021).
As noted in the article (Seckam et al, 2021), data on wound-related QoL were collected before and at the end of treatment with Cutimed® Siltec® Sorbact® via the validated Wound-QoL questionnaire developed by Blome et al (2014) and Augustin et al (2017). It was concluded that the improvement of the Wound-QoL scores from before to after the study suggested a positive impact of being treated with the study product. After our study had been published, a paper by Topp et al (2021) provided estimates of the minimal important difference (MID), defined as a change in QoL that a patient would consider meaningful, such that the patient would judge a treatment to be beneficial and worthy of repeating. This now allows us to interpret the QoL scores found in our study in light of the MID (Table 1).
Table 1. Wound-QoL improvement as compared to minimal important difference (MID) estimates
| Subscale Wound-QoL | Before treatment score | After treatment score | Score difference | MID estimates* |
|---|---|---|---|---|
| Global QoL score | 1.93 | 1.31 | 0.62 | 0.47-0.52; proposed overall estimation: 0.50 |
| Body (QoL constructs 1-5) | 1.458 | 0.894 | 0.564 | 0.47–0.57 |
| Psyche (QoL constructs 6-10) | 2.438 | 1.808 | 0.63 | 0.56–0.63 |
| Everyday life (11-16) | 1.81 | 1.35 | 0.46 | 0.41–0.62 |
Calculation of QoL scores
Global and subscale QoL scores (Table 1) were calculated before and after treatment using Cutimed Siltec Sorbact absorbent bacteria-binding foam dressings for this cohort of patients. The global score improved from 1.93 to 1.31; this difference of 0.62 is above the proposed MID value of 0.5 for improvement according to Topp et al (2021), indicating relevant QoL improvements for patients.
Looking at the subscale analysis on impairments related to ‘psyche’ among this cohort, the improvement can also be regarded relevant (Table 1). For the improvements related to ‘body’ and ‘everyday life’ this was less clear as the observed mean scores fell within the range of MID estimates, for which no overall estimation was proposed.
Please see Seckam et al (2021), Table 7, page S28, for comprehensive data relating to QoL. It is important to note that item 17 (financial burden) was not considered for the final calculation because Poland and Germany differ in how their healthcare systems are financed.
QoL scores were calculated and compared with the MIDs in order to detect a clinically relevant change in patient wound care. The use of such tools is useful for supporting patient engagement, concordance and adherence with recommended treatment regimens.
Future wound-care studies should adopt such QoL tools for better patient reported outcomes when using wound-care products and throughout patient wound-care journeys.