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Patients’ understanding of cellulitis and views about how best to prevent recurrent episodes: mixed-methods study in primary and secondary care

Teasdale, E. J.; Lalonde, A.; Muller, I.; Chalmers, J.; Smart, P.; Hooper, J.; El-Gohary, M.; Thomas, K. S.; Santer, M.

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Authors

E. J. Teasdale

A. Lalonde

I. Muller

J. Chalmers

P. Smart

J. Hooper

M. El-Gohary

M. Santer



Abstract

Background: Cellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately one-third of cases. The only proven strategy to reduce the risk of recurrence is long-term, low-dose antibiotics. Given current concerns about antibiotic resistance and the pressure to reduce antibiotic prescribing, other prevention strategies are needed. Objectives: To explore patients’ views about cellulitis and different ways of preventing recurrent episodes. Methods: Adults aged ≥ 18 years with a history of first-episode or recurrent cellulitis were invited through primary care, hospitals and advertising to complete a survey, take part in an interview or both. Results: Thirty interviews were conducted between August 2016 and July 2017. Two hundred and forty surveys were completed (response rate 17%). Triangulation of quantitative and qualitative data showed that people who have had cellulitis have wide-ranging beliefs about what can cause cellulitis and are often unaware of risk of recurrence or potential strategies to prevent recurrence. Enhanced foot hygiene, applying emollients daily, exercise and losing weight were more popular potential strategies than the use of compression stockings or long-term antibiotics. Participants expressed caution about long-term oral antibiotics, particularly those who had experienced only one episode of cellulitis. Conclusions: People who have had cellulitis are keen to know about possible ways to prevent further episodes. Enhanced foot hygiene, applying emollients daily, exercise and losing weight were generally viewed to be more acceptable, feasible strategies than compression or antibiotics, but further research is needed to explore uptake and effectiveness in practice.

Journal Article Type Article
Acceptance Date Nov 16, 2018
Online Publication Date Nov 19, 2018
Publication Date Apr 1, 2019
Deposit Date Nov 27, 2018
Publicly Available Date Nov 20, 2019
Journal British Journal of Dermatology
Print ISSN 0007-0963
Electronic ISSN 1365-2133
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 180
Issue 4
Pages 810-820
DOI https://doi.org/10.1111/bjd.17445
Keywords Dermatology
Public URL https://nottingham-repository.worktribe.com/output/1314140
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17445
Additional Information This is the peer reviewed version of the following article: Teasdale, E. , Lalonde, A. , Muller, I. , Chalmers, J. , Smart, P. , Hooper, J. , El‐Gohary, M. , Thomas, K. and Santer, M. (2018), Patients’ understandings about cellulitis and views about how best to prevent recurrent episodes: mixed methods study in primary and secondary care. Br J Dermatol. Accepted Author Manuscript, which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17445. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions

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