Compression bandaging: Identification of factors contributing to non-concordance

Aims: To elucidate reasons for non-concordance with compression bandaging, subject the identified reasons to thematic analysis and use the resultant themes as the basis for the development of a screening tool to identify those patients at risk of non-concordance with compression bandaging. Method: A literature search was undertaken using the terms 'concordance', 'compression bandaging' and 'venous leg ulcer'. Articles were included if they discussed reasons for non-concordance with compression bandaging. Forty-one articles were identified which met inclusion criteria. The full texts were read and the reasons for non-concordance tabulated. These were then subjected to thematic analysis. Results: Six themes emerged. These were termed knowledge deficit; resource deficit; psychosocial issues; pain/discomfort; physical limitations; and wound management. These themes were used to develop a screening tool to identify patients who exhibit barriers to concordance with compression bandaging. Discussion: Compression bandaging is the recommended treatment for venous leg ulceration1-3. However, the degree of concordance with compression bandaging therapy remains at sub-optimal levels4,5. Consequently patients experience protracted ulceration. The development of a risk screening tool for non-concordance will permit targeted intervention to address barriers to concordance before the patient has a poor experience of compression therapy.