title: [Compression and venous leg ulcer: observational study in general medicine].
abstract: BACKGROUND
  Multi-component compression, inelastic, short stretched or coated strips bandages, and class 4 stockings have been recommended since 2010 by the French Superior Health Authority as first- and second-line treatment for venous leg ulcers.
  
  
  OBJECTIVE
  Assess the prescribing habits and knowledge of general practitioners about compression therapy and determine factors predictive of prescriptions consistent with recommendations.
  
  
  METHODS
  Evaluation study of professional practices conducted during a six-week period. A questionnaire was sent to 210 general practitioners asking them to report their prescribing practices and the last prescription written for a patient with venous ulcers.
  
  
  RESULTS
  The response rate was 36.2% (76 responses). For the last patient seen, long stretched bands were prescribed by 50.8% of responders, stockings by 40% and multi-component compression by 7.7%. Stockings were class 2 for 87.7% of the prescriptions. Knowledge of short stretched bands and multi-component compression was reported by 45.8% and 38.9% of general practitioners respectively. Guidelines were followed by 10.8% of the physicians. No factor related to the general practitioner (age, sex, modalities of exercise, experience and education), to the patients (age, sex, under-nutrition, autonomy) or to the leg ulcer (size, exudates, course, complexity of care), was associated with compliance or not with the guidelines. General practitioner training enabled a non-significant improvement of prescriptions (14.3% vs 4%, P=0.24).
  
  
  CONCLUSIONS
  Compliance with the guidelines for compression therapy is insufficient in general medicine. Better training and knowledge of modalities for compression therapy could be useful to improve prescription practices and encourage use of multi-component compression and short stretched bandages, known to be more effective and better tolerated.
authors.affiliation: Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Begarin
authors.affiliation: Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France; Département de médecine générale, faculté de médecine pharmacie de Rouen, 1, boulevard Gambetta, 76000 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Beaujour
authors.affiliation: Département de médecine générale, faculté de médecine pharmacie de Rouen, 1, boulevard Gambetta, 76000 Rouen, France.
authors.forename: P
authors.initials: P
authors.lastname: Fainsilber
authors.affiliation: Département de médecine générale, faculté de médecine pharmacie de Rouen, 1, boulevard Gambetta, 76000 Rouen, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Hermil
authors.affiliation: Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France. Electronic address: herve.levesque@chu-rouen.fr.
authors.forename: H
authors.initials: H
authors.lastname: Lévesque
authors.affiliation: Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Benhamou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058128:Compression Bandages; D005260:Female; D005602:France; D058005:General Practitioners; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D014647:Varicose Ulcer / Q000628:therapy*
keywords: Compression médicale; Compression therapy; General medicine; Leg ulcer; Médecine générale; Ulcère de jambe; Ulcère veineux; Venous ulcer