Recently, we read an article in Kaiser Health News, When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion. What is extremely interesting, and at the same time more than alarming, is the article’s assertion that there is a severe lack of research related to chronic wounds.
The National Institutes of Health (NIH) invests over $32B in health related research annually, only slightly more than the amount spent annually on the care of persons with chronic wounds. More than 80% of the NIH's funding is awarded through almost 50,000 competitive grants to more than 300,000 researchers at more than 2,500 universities, medical schools, and other research institutions in every state and around the world. But an independent review estimates that the NIH spends 0.1 percent studying wound treatment, roughly the same spent on studying Lyme disease although there are over 6.5M persons in the United States struggling with chronic wounds. The article points out that a Health and Human Services review of 10,000 studies examining treatment of leg wounds, also known as venous ulcers, found that only 60 of them met basic scientific standards, leaving their results classified as unreliable and unactionable.
While scientists struggle to come up with treatments that are more effective, patients with chronic wounds are dying. The five-year mortality rate for patients with some types of diabetic wounds is more than 50 percent higher than breast and colon cancers, according to an analysis led by David Armstrong, DPM, MD, PhD, a professor of surgery and former director of the Southern Arizona Limb Salvage Alliance and currently Professor of Surgery and Limb Salvage and Director of the Southwestern Academic Limb Salvage Alliance (SALSA) at the Keck School of Medicine at the University of Southern California.
According to some estimates, Medicare alone spends at least $25 billion a year treating these chronic wounds. But many widely used treatments aren’t supported by credible research. The wound care product business, worth at least an estimated $5 billion a year, continues to grow while some products do not have adequate clinical evidence to support their use. The vast majority of the studies are funded or conducted by companies that manufacture these products while independent academic research is negligible for a problem that continues to grow, especially as chronic conditions like diabetes continues to grow across the country. Between 2009 and 2034, the number of people with diagnosed and undiagnosed diabetes will increase from 23.7 million to 44.1 million according to the American Diabetes Association (read article here).
As reported in the Kaiser Health article, “It’s true that we may be paying for treatments that don’t work,” said Sean Tunis, former Chief Medical Director of Medicare and now CEO of the nonprofit Center for Medical Technology Policy, which has worked with the federal government to improve research. “But it’s just as tragic that we could be missing out on treatments that do work by failing to conduct adequate clinical studies.”
Although doctors and researchers have been calling on the federal government to step in for at least a decade, the National Institutes of Health and the Veterans Affairs and Defense departments haven’t responded with any significant research initiative.
“The bottom line is that there is no pink ribbon to raise awareness for festering, foul-smelling wounds that don’t heal,” said Caroline Fife, a wound care doctor in Texas. “No movie star wants to be the poster child for this, and the patients … are old, sick, paralyzed and, in many cases, malnourished.”
In the emerging era of value based care, where incentives are being aligned to produce higher quality clinical outcomes at a lower cost per patient, research and high quality data is imperative. With exponential advancements in artificial intelligence and machine learning, outcome data from wound treatments will inform algorithms producing an evolution in the evidence base.
At Corstrata, we are committed to collecting data regarding the efficacy of wound treatments used on the chronic wounds of our customer’s patients. Corstrata utilizes mobile technologies to create access to our board-certified wound care specialists. Additionally, Corstrata wound experts collaborate with providers to develop a wound treatment plan that includes proper assessment, recommendation of evidence based, best practice wound treatments, staff education, pressure ulcer prevention program, and wound formulary redesign. Corstrata provides wound image and video consults that include accurate identification of the wound type and associated staging, precise wound measurement, and recommended treatment and wound dressing.
Contact us today for Expert Wound & Ostomy Care. Anywhere.