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A RCT in high risk nursing home residents to compare cost-effectiveness of a static air mattress and alternating mattress to prevent pressure ulcers

Brecht Serraes (UGent) , Dimitri Beeckman (UGent) , Charlotte Anrys (UGent) , Hanne Van Tiggelen (UGent) , Ann Van Hecke (UGent) and Sofie Verhaeghe (UGent)
(2019)
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Abstract
Background: Pressure ulcers are a worldwide health concern. To prevent pressure ulcers, a variety of support surfaces is available to reduce pressure. The evidence about the difference in effectiveness between static air support surfaces and alternating air pressure support surfaces is lacking because of methodological limitations and large heterogeneity in published studies. Present trail aimed to compare the efficacy and cost- effectiveness of the two support surface types to prevent pressure ulcers in a nursing home population at risk. Methods: A multicentre RCT was performed in a convenience sample of 26 nursing homes between April 2017 and May 2018. A consecutive sample of 308 patients were included. Patients were allocated to the experimental group (n=154): static air support surfaces (Repose®: mattress overlay, cushion and wedge, Frontier Medical Group, New South Wales, UK) and control group (n=154): alternating air pressure mattress, alternating cushions. The primary outcome was pressure ulcer incidence category II-IV within a 14-day observation period. Health economic measures from an organizational perspective are a secondary endpoint based on purchase cost of support surfaces. Results: The cumulative incidence of pressure ulcers category II–IV was 8.4% (n=26/308). A significant lower incidence was found in the experimental group (n=8/154, 5.2%) compared to the control group (n=18/154, 11.7%)(p=0.04). The median time to develop a pressure ulcer category II-IV was significant longer in the experimental group (10.5 days, IQR 1-14) compared with the control group (5.4 days, IQR 1-12), Mann-Whitney U=37.00,p=0.05). The probability to remain pressure ulcer free did significant differ between the two groups (log-rank X=4.051,df=1, p=0.04). The overall purchase cost of the experimental group was lower compared to the control group. Conclusion: A static air mattress was significantly more effective and had a lower financial burden compared to alternating air pressure mattress to prevent pressure ulcers in a nursing home population.

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Chicago
Serraes, Brecht, Dimitri Beeckman, Charlotte Anrys, Hanne Van Tiggelen, Ann Van Hecke, and Sofie Verhaeghe. 2019. “A RCT in High Risk Nursing Home Residents to Compare Cost-effectiveness of a Static Air Mattress and Alternating Mattress to Prevent Pressure Ulcers.” In .
APA
Serraes, B., Beeckman, D., Anrys, C., Van Tiggelen, H., Van Hecke, A., & Verhaeghe, S. (2019). A RCT in high risk nursing home residents to compare cost-effectiveness of a static air mattress and alternating mattress to prevent pressure ulcers. Presented at the CARE4 International Scientific Nursing and Midwifery Congress, Third Edition.
Vancouver
1.
Serraes B, Beeckman D, Anrys C, Van Tiggelen H, Van Hecke A, Verhaeghe S. A RCT in high risk nursing home residents to compare cost-effectiveness of a static air mattress and alternating mattress to prevent pressure ulcers. 2019.
MLA
Serraes, Brecht et al. “A RCT in High Risk Nursing Home Residents to Compare Cost-effectiveness of a Static Air Mattress and Alternating Mattress to Prevent Pressure Ulcers.” 2019. Print.
@inproceedings{8599652,
  abstract     = {Background: Pressure ulcers are a worldwide health concern. To prevent pressure ulcers, a variety of support surfaces is available to reduce pressure. The evidence about the difference in effectiveness between static air support surfaces and alternating air pressure support surfaces is lacking because of methodological limitations and large heterogeneity in published studies. Present trail aimed to compare the efficacy and cost- effectiveness of the two support surface types to prevent pressure ulcers in a nursing home population at risk.
Methods: A multicentre RCT was performed in a convenience sample of 26 nursing homes between April 2017 and May 2018. A consecutive sample of 308 patients were included. Patients were allocated to the experimental group (n=154): static air support surfaces (Repose{\textregistered}: mattress overlay, cushion and wedge, Frontier Medical Group, New South Wales, UK) and control group (n=154): alternating air pressure mattress, alternating cushions. The primary outcome was pressure ulcer incidence category II-IV within a 14-day observation period. Health economic measures from an organizational perspective are a secondary endpoint based on purchase cost of support surfaces.
Results: The cumulative incidence of pressure ulcers category II--IV was 8.4\% (n=26/308). A significant lower incidence was found in the experimental group (n=8/154, 5.2\%) compared to the control group (n=18/154, 11.7\%)(p=0.04). The median time to develop a pressure ulcer category II-IV was significant longer in the experimental group (10.5 days, IQR 1-14) compared with the control group (5.4 days, IQR 1-12), Mann-Whitney U=37.00,p=0.05). The probability to remain pressure ulcer free did significant differ between the two groups (log-rank X=4.051,df=1, p=0.04). The overall purchase cost of the experimental group was lower compared to the control group.
Conclusion: A static air mattress was significantly more effective and had a lower financial burden compared to alternating air pressure mattress to prevent pressure ulcers in a nursing home population.},
  author       = {Serraes, Brecht and Beeckman, Dimitri and Anrys, Charlotte and Van Tiggelen, Hanne and Van Hecke, Ann and Verhaeghe, Sofie},
  language     = {eng},
  location     = {Leuven},
  title        = {A RCT in high risk nursing home residents to compare cost-effectiveness of a static air mattress and alternating mattress to prevent pressure ulcers},
  year         = {2019},
}