BG05 Barriers to tackling venous stasis dermatitis: a national survey on gerontologists’ approach to management

Abstract Venous stasis dermatitis affects approximately 20% of patients aged > 70 years. The World Health Organization reported that in 2021 there were 215 million European citizens aged > 60 years, a figure expected to reach > 300 million by 2050. Geriatric dermatology represents a pivotal expanding subcategory of dermatology. Our research project assessed the approach of Irish gerontologists to venous insufficiency. We designed a 12-question survey, which was distributed to registered members of the Irish Gerontological Society via registered email addresses The Irish Gerontological Society (established 1951) is the primary physician advocacy body for care of older persons in Ireland. We received 63 responses: 48% (n = 30) from consultant geriatricians, 25% (n = 16) from specialist trainee registrars and 27% (n = 17) from senior house officers. Overall, 94% (n = 59) reported that they conducted lower-limb examinations either ‘very frequently’ or ‘quite frequently’. In total, 38% (n = 24) identified encountering signs of venous insufficiency very frequently in their clinic, with 56% (n = 25) identifying this as occurring quite frequently. When questioned about prescribing in flares of venous stasis dermatitis, 25% (n = 16) reported that they do not routinely prescribe a topical corticosteroid in flares, while 59% (n = 37) identified doing this ‘sometimes’. Overall, 41% (n = 26) identified a patient’s fall risk as a barrier to emollient prescription. Eleven (17%) reported being very confident in managing venous eczema, 65% (n = 41) quite confident and 17% (n = 11) not confident. Around one-third (31%, n = 20) routinely advise elevation for lower-leg oedema. Over half (57%, n = 36) identified a patients’ mobility status as a factor preventing prescription of topical treatments to the lower limb. In total, 73% (n = 49) report ‘sometimes’ advising compression stockings for lower-limb oedema, while 16% (n = 10) report doing this regularly. Nine (14%) have referred a patient with venous eczema to dermatology. Most (81%, n = 51) report being ‘quite confident’ in managing patients with lower-limb ulceration. When we asked participants to identify whether compression is an effective treatment for leg ulcers, 57% (n = 36) reported this to be true and 43% (n = 27) false. The most commonly identified barriers to management of lower-limb ulceration were lack of care support, absence of evidence-based protocols and lack of access to wound care products in the community. Our survey has highlighted that gerontologists assess patients with venous stasis dermatitis at high frequency in clinic. Our study highlights that a patient’s mobility status may impact the degree of treatment provided for patients with venous eczema, with 59% of responses stating that a patient’s mobility prevents the clinician from prescribing topical treatments to the lower limb often. Our study shows, in the era of an ageing population, that education regarding skin conditions affecting older patients needs to be prioritized.