Pain in pure and mixed aetiology venous leg ulcers: a three-phase point prevalence study

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Abstract
This study aimed to determine the point prevalence of venous leg ulcer pain over three seasons (autumn, winter and spring). It also collated profiles of individuals with venous ulceration and described the characteristics of people with and without venous leg ulcer pain. The study sample comprised 255 people with pure and mixed venous leg ulcers who were receiving care in a Canadian community leg ulcer service. Prevalence was determined by the number of individuals who had experienced pain in the past 24 hours. The profile of individuals was developed by analysing sociodemographic, circumstance-of-living, clinical and health-related quality-of-life data collected on admission to the leg ulcer service. Over the three prevalence periods, the prevalence of pain for the total sample ranged from 48% to 54%. Prevalences at each of the study periods for individuals who had been receiving care for less than 13 weeks, and for the first measure of pain only, were almost identical, ranging from 48-59%. The mean pain-severity score was less than three (out of 10) in all three periods. Of the individuals with pain, 50% or more used analgesia and, of these, over 75% reported it was effective. The profile of participants with pain was similar to those without it, except that the former were significantly more likely to have osteoarthritis, a foot ulcer, to have been attending the leg service for a shorter time period and to have a lower SF-12 mental health component score. These results demonstrate that leg ulcer management must include pain assessment and consideration of the factors that may be associated with pain. A large prospective repeated measures study is needed to increase understanding of the extent of pain, the use and efficacy of analgesia, and the factors that may be related to experiencing pain.