Management of chronic venous disease by primary care

Abstract

Objective: To assess the patterns of referral for chronic venous disease (CVD).

Method: General practitioners (GPs) were invited by an email to complete a validated online survey evaluating the referral and community management of CVD.

Results: A total of 138 participants were recruited. Most GPs (85%) saw fewer than 50 patients with CVD a year. Thirty-one percent were aware of National Institute for Clinical Excellence referral guidelines for CVD and 36% were aware of and agreed with local referral guidelines. Eleven percent were aware of clinical venous scoring systems. Sixty-three percent believed mild CVD would progress and 84% believed treatment would improve the quality of life. Sixteen referred C3 disease, 43% C4, 37% C5 and 65% C6 disease. Forty-one percent would refer on request. Pain symptoms increased referral in C2 disease. Endothermal ablation was believed available to 33% and traditional stripping to 62% and 27% were unaware of the treatment options. Forty-five percent were happy to provide postoperative care.

Conclusions: Despite national guidelines, the management of CVD in the UK is variable.

Keywords: chronic venous disease; primary care; referral patterns; varicose veins.