Management of chronic venous disease in general practice: a cross-sectional study of first line care in Belgium.

Abstract

The aim of this observational study was to examine how general practitioners (GP) in Belgium treat patients with chronic venous disease (CVD). This cross-sectional study was carried out in Belgium by GPs who recruited 15 consecutive patients who were consulting them and suffered from CVD. By following a standardized questionnaire, they collected information on patient characteristics, risk factors, signs and symptoms, and how they were being managed. Two hundred fifty-three GPs recruited 3055 patients, who were predominantly female (75.6%), with a mean age of 62.7 (SD=14.6). 20.1% of the population suffered from CVD without clinical signs (C0s). 8.7% of the population had advanced disease (C5-C6). Most common symptoms were respectively "heavy legs" (43.7%), "swollen feeling" (28%) and "pain" (24.1%). The primary care physicians decided 95.3% of patients needed therapy of some sort. The most used treatment option used in 83.3% of subjects was the use of venoactive medication. Lifestyle advice was recommended in 64.5% of patients and recommendations regarding compression stockings were given in 46.9% of patients. Referral to a specialist was warranted for 24.5% of the population. Patients with a lower C Classification were more often treated conservatively compared to those with a higher C Classification. Most patients were treated conservatively, which includes lifestyle changes, medication, and compression. Only one in four patients is referred to a vascular specialist and this referral is significantly positively correlated with the C Classification.