Response to Letter—Qualitative Exploration of the Barriers and Facilitators to Early Lower Limb Assessment and Onward Referral for Specialist Treatment for Patients With Venous Ulceration
Layla Bolton Saghdaoui, Smaragda Lampridou, Alun Huw Davies, Sarah Onida, Mary Wells
Abstract
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Taxonomy
TopicsDiagnosis and Treatment of Venous Diseases · Diabetic Foot Ulcer Assessment and Management · Peripheral Artery Disease Management
Dear Authors,
We would like to thank you for taking the time to read and provide insightful comments on our paper. This qualitative study served as preliminary work conducted as part of a pre‐doctoral project. As noted in our study limitations, we very much agree with the need to integrate behavioural theory and provide policy recommendations, however further work is needed to do this comprehensively. This work is currently underway in the form of a mixed methods PhD project funded by the National Institute of Health and Care Research (NIHR) [1]. Building on the findings of this study and the qualitative evaluation of the implementation of the National Wound Care strategy [2], this project follows the Person‐Based Approach [3] and encompasses the following:
- A national survey of healthcare professionals across the UK evaluating current referral practices and services available to treat patients with venous ulceration. This was supported by a simplified version of the survey sent to every Trust in the country as a freedom of information request (Manuscript under review—27/01/2025).
- A systematic review of interventions to improve referral for chronic health conditions (Accepted for publication in BMC Systematic Reviews—07/Feb/2025).
- A larger UK qualitative study informed by the Theoretical Domains Framework [4] and including a broader range of healthcare professionals, patients and their caregivers/significant others.
- A planned Delphi study to refine data gathered in previous work packages and provide robust policy and practice recommendations.
Findings from the national survey and systematic review have been presented at recent national and international conferences. We look forward to disseminating further work over the coming months.
We would be happy to explore the possibility of potential collaboration should the authors be interested.
The reference list from the paper itself. Each links out to its DOI / PubMed record.
- 1National Institute of Health and Care Research , “Improving Pathways of Care for Patients With Venous Leg Ulceration,” 2023, https://fundingawards.nihr.ac.uk/award/NIHR 302917.
- 2National Wound Care strategy , “Implementing the Lower Limb Recommendations and Learnings From the First Tranche Implementation Sites,” 2024, https://www.nationalwoundcarestrategy.net/wp‐content/uploads/2024/07/NWCSP‐Final‐Evaluation‐Report‐Summary‐Version_final.pdf.
- 3L. Yardley , B. Ainsworth , E. Arden‐Close , and I. Muller , “The Person‐Based Approach to Enhancing the Acceptability and Feasibility of Interventions,” Pilot and Feasibility Studies 1 (2015): 37.27965815 10.1186/s 40814-015-0033-z PMC 5153673 · doi ↗ · pubmed ↗
- 4L. Atkins , J. Francis , R. Islam , et al., “A Guide to Using the Theoretical Domains Framework of Behaviour Change to Investigate Implementation Problems,” Implementation Science 12, no. 1 (2017): 77.28637486 10.1186/s 13012-017-0605-9PMC 5480145 · doi ↗ · pubmed ↗