title: Therapeutic use of compression stockings for orthostatic hypotension: an assessment of patient and physician perspectives and practices.
abstract: BACKGROUND
  Elastic compression stockings (ECS) can be used as a non-pharmacological therapeutic option for older patients with orthostatic hypotension (OH). We aimed to investigate the practices and views of patients and physicians regarding the use of ECS for OH.
  
  
  METHODS
  Two surveys were designed. The first was sent to 90 patients known to have been prescribed ECS for OH. This questionnaire included items related to the frequency of use and issues related to non-compliance. The second was sent to 69 consultant physicians in geriatric medicine. This included items related to prescribing practices and perceived patient compliance.
  
  
  RESULTS
  Sixty-seven patients responded (response rate, 74%) and of those 64% were female. Mean age (SD) was 75.1 years (10.5), range 45-91 years. Thirty-three per cent wore ECS daily, whereas 43% never used them. Over half (51%) of the patients reported difficulty in application and 31% reported discomfort. Those aged 75 or older were more likely to report difficulty in application (P=0.003). Forty-eight physicians responded (response rate, 70%). Eighty-nine per cent prescribe ECS for OH. There were significant differences between the frequency of use reported by patients and predicted by physicians (P<0.001), with physicians less likely to predict daily or non-use. Eighty-nine per cent of physicians predicted that difficulty in application was the main reason for non-compliance.
  
  
  CONCLUSIONS
  Although prescribed frequently, the use of ECS in patients with OH is often limited by issues related to practicality. Physicians correctly predicted the main reasons for non-compliance although underestimated the scale of patient compliance with ECS.
authors.affiliation: Department of Medicine, Division of Ageing and Therapeutics, University Hospital Limerick, Ireland.
authors.forename: Colin
authors.initials: C
authors.lastname: Quinn
authors.affiliation: Department of Bioelectronic Engineering, National University of Ireland, Galway, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: Deegan
authors.affiliation: Department of Medicine, Division of Ageing and Therapeutics, University Hospital Limerick, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Cooke
authors.affiliation: Department of Medicine, Division of Ageing and Therapeutics, University Hospital Limerick, Ireland.
authors.forename: Sheila
authors.initials: S
authors.lastname: Carew
authors.affiliation: Graduate Entry Medical School, University of Limerick, Ireland.
authors.forename: Ailish
authors.initials: A
authors.lastname: Hannigan
authors.affiliation: Centre for Interventions in Infection, Inflammation and Immunity, University of Limerick, Ireland.
authors.forename: Colum
authors.initials: C
authors.lastname: Dunne
authors.affiliation: Department of Medicine, Division of Ageing and Therapeutics, University Hospital Limerick, Ireland.
authors.forename: Declan
authors.initials: D
authors.lastname: Lyons
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010361:Patients / Q000523:psychology*; D010465:Perception; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: elastic compression stockings; older people; orthostatic hypotension; patient survey; physician survey