Videoconferencing for Follow-Up of Pressure Injury: Period Prevalence, Risks, Treatment and Financial Consequences

Abstract

Pressure injury is a serious complication after spinal cord injury, and the occurrence is high during the acute care rehabilitation at the spinal cord unit, as well as after discharge back home to the municipality. Health services where the spinal cord unit and the caregivers in the municipalities cooperate, is necessary to optimize the follow-up. The aims of this thesis were to to assess the prevalence of pressure injury and to identify risk factors for pressure injury during acute rehabilitation after a spinal cord injury, by reviewing medical records. Further aims were to assess health related quality of life, healing, satisfaction and cost-utility in a randomized controlled trial among persons with spinal cord injury, where one group received traditional outpatient follow-up, and the other received remote videoconference follow-up in addition to traditional outpatient care. Self-report questionnaires and custom-made assessment scales were used. The occurrence of pressure injury in the population was 16%, and identified risk factors were the completeness of the spinal cord injury, bowel and bladder dysfunction, comorbidity, e.g. diabetes mellitus type 1 and depression, as well as drug abuse. The results in the randomized controlled trial showed no significant differences in health related quality of life, healing, experienced satisfaction, safety or patient-empowerment between the two groups. The cost-utility analysis showed that additional videoconference follow-up was more costly, but also a bit more effective than traditional follow-up. Overall, pressure injury is a serious problem among people with spinal cord injury, and videoconference follow-up seems to be a safe remote treatment option for people with spinal cord injury and pressure ulcer.