Abstract
Study design:
A multicentre, prospective, assessor-blinded, parallel randomised controlled trial.
Objectives:
The objective of the trial was to determine the effectiveness of telephone-based management of pressure ulcers in people with spinal cord injury (SCI) in low- and middle-income countries.
Methods:
One hundred and twenty people with SCI living in the community were recruited through three hospitals in India and Bangladesh between November 2013 and March 2016. Participants had sustained an SCI >3 months prior and had a pressure ulcer. Participants were randomly allocated (1:1) to a control or intervention group. Participants in the control group received no intervention. Participants in the intervention group received weekly advice by telephone for 12 weeks about the management of their pressure ulcers from a trained health-care professional. Outcomes were measured by a blinded assessor at baseline and 12 weeks. There was one primary outcome, namely, the size of the pressure ulcer and 13 secondary outcomes.
Results:
The mean between-group difference for the size of the pressure ulcer at 12 weeks was 2.3 cm2 (95% confidence interval −0.3 to 4.9; favouring the intervention group). Eight of the 13 secondary outcomes were statistically significant.
Conclusion:
The results of our primary outcome (that is, size of pressure ulcer) do not provide conclusive evidence that people with SCI can be supported at home to manage their pressure ulcers through regular telephone-based advice. However, the results from the secondary outcomes are sufficiently positive to provide hope that this simple intervention may provide some relief from this insidious problem in the future.
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Acknowledgements
The authors acknowledge the assistance of the project coordinators (Mr Jaspreet Singh Sethi, Md Abdullah and Mr Ranjit Roy) at the trial sites, the participants and staff who assisted in recruiting participants.
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MA conducted this trial in partial fulfilment of his PhD. He was supported through a Prime Minister's Australia Asia Post Graduate Research Endeavour Award for the duration of his PhD candidature. The trial was supported by the John Walsh Centre for Rehabilitation Research. The authors declare no conflict of interest in trial design, data collection and analysis, decision to publish, or preparation of the manuscript. Those supporting this research have no financial interests in the results. The authors and all organisations associated with the authors did not confer any benefit.
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Arora, M., Harvey, L., Glinsky, J. et al. Telephone-based management of pressure ulcers in people with spinal cord injury in low- and middle-income countries: a randomised controlled trial. Spinal Cord 55, 141–147 (2017). https://doi.org/10.1038/sc.2016.163
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DOI: https://doi.org/10.1038/sc.2016.163
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