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Special Topic: A Study on Varicose Vein Treatments, Patient Reported Outcome Measures (PROMs) in England

Publication date: 09:30 February 11, 2016

Summary

Patient Reported Outcome Measures (PROMs) have been collected for varicose vein treatment along with three other conditions since 2009/10. Patients undergoing PROMs-eligible varicose vein treatment are asked to complete a questionnaire before treatment and again three months after treatment.

There are a number of different ways that varicose veins can be treated, ranging from surgical removal to more modern, less invasive techniques. In many cases these different techniques are used in combination with one another within the same episode of care.

In July 2013, the National Institute of Clinical Excellence (NICE) issued guidance recommending the adoption of these new techniques where appropriate, in preference to traditional surgical methods.

The purpose of this PROMs special topic is to look at the differences in outcome between these treatments as reported by the patient on their PROMs questionnaires.


Key Facts

  • The proportion of varicose vein procedures being performed which are covered by the National Institute for Health and Care Excellence (NICE) guidance has increased since PROMs began in 2009/10, primarily due to the increase in endothermal procedures in preference to conventional surgery.
  • The proportion of varicose vein procedures being performed which are covered by NICE guidance varies considerably by provider from 0 per cent to nearly 100 per cent. Providers which perform a large number of varicose vein procedures are more likely to offer the procedures covered by the NICE guidance.
  • Health gain varies by the type of procedure (or combination of treatments) used. Surgical treatments show the highest health gains after treatment, followed by endothermal procedures then foam sclerotherapy. Patients undergoing foam sclerotherapy on average score a greater health gain than other types of sclerotherapy, according to the five year sample of finalised data in this report; as illustrated in the graph below.

  • Average health gain measured by Aberdeen Varicose Vein Questionnaire (AVVQ) by procedure type 2009/10 - 2013/14

     

    • Participation in PROMs varies by procedure type, with patients undergoing surgical treatment more likely to participate than endothermal or sclerotherapy treatment patients.
    • Complications following treatment vary considerably by treatment type. Patients who undergo surgery procedures are more likely to report post-operative complications such as wound problems or bleeding than patients who undergo endothermal or foam sclerotherapy treatment.

    Coverage

    Date Range: 01 April 2009 to 31 March 2015
    Geographical coverage: England
    Geographical granularity: Country, NHS Trusts, Hospital Trusts, Independent Sector Health Care Providers, Clinical Commissioning Groups

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