Enhancing Cure and Care for Patients with Chronic Venous Disease

Chronic venous disease (CVD) is highly prevalent and leads to symptoms ranging from pain and skin changes to chronic ulcers, severely affecting quality of life and generating substantial healthcare costs. This thesis aimed to determine whether a one-stop clinic and optimised diagnostic and conservative strategies improve outcomes in venous leg ulcers and post-thrombotic syndrome (PTS). A new one-stop clinic model for venous leg ulcers was evaluated using clinical outcomes, patient interviews and cost analyses. Systematic reviews were conducted on the duration of compression therapy after deep vein thrombosis (DVT) and on the effects of exercise following DVT. Additionally, a pilot study assessed the feasibility of treadmill testing to evaluate venous claudication before and after venous stenting. The one-stop clinic improved chance of ulcer healing  and was highly valued by patients for its coordinated, specialist-led care. The cost analysis suggested potential reductions in healthcare utilisation. Evidence showed that the duration of compression therapy can be safely individualised when patients are closely monitored. Exercise interventions after DVT improved pain, quality of life and reduced the long-term severity of PTS. Treadmill testing proved feasible for individual assessment, though its generalisability and applicability across wider patient groups have yet to be established. Findings highlight the importance of structured, personalised care pathways and support the integration of exercise therapy and emerging digital tools into future CVD management.