Katherine A Mockford1*, Julie Hemingway2, Maureen Naylor1, Line O Rethmeier1, Jonathan Walker1, Fiona Mthombeni1 and DG Jayne2
1Department of Colorectal Surgery, Hull University Teaching Hospitals NHS Trust, UK
2Department of Colorectal Surgery, Leeds Teaching Hospitals NHS Trust, UK
Objectives: To clarify the prevalence and costs of Peristomal Skin Complications (PSC) suffered by patients with a stoma in the community, identify risk factors for such complications, and determine if a specialist nurse led intervention programme reduces stoma associated healthcare costs. Materials and Methods: Ostomate from 179 primary care practices was invited to attend a review from a stoma care specialist nurse between June 2016 and February 2018, recording the prevalence of complications. Interventions included: clinical advice, stoma product advice and changes. To determine which factors were more likely to increase the risk of PSC; a binary logistic regression was performed. An established cost analysis model was used to quantify the annual cost of identifying and treating PSC. Results: Initial visits were conducted with 1968 ostomates over 21 months. PSC were identified in 24% of the patients (n=469).Comparative risk factors for PSC were; a recently formed stoma (<6 months), an ileostomy rather than a colostomy and inflammatory bowel disease rather than bowel cancer. Annual mean cost of identifying and treating PSC was £521/patient. The estimated total annual cost savings for the cohort from avoided NHS appointments was £31/patient. A 10% decrease in stoma products used corresponded to £229/patient annual cost saving. Conclusion: Stoma patients currently experience a range of complications which can last several years after stoma formation. Clinical review by nurse specialists is associated with significant cost savings, including reductions in unplanned visits with healthcare specialists and decrease in products used.
Stoma; Ostomate; Skin complications; Ileostomy; Colostomy
Mockford KA, Hemingway J, Naylor M, Rethmeier LO, Walker J, Mthombeni F, et al. A Prospective Cohort Study of Stoma Complications in the Community. Clin Surg. 2019; 4: 2540..