Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

Problem

Cellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition. This study aimed to explore patients’ perceptions and understanding of cellulitis and their information needs.

Approach

We conducted a mixed methods study comprising semi-structured, face-to-face interviews and a cross-sectional survey. We recruited through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.

Findings

Thirty interviews were conducted between August 2016 and July 2017. Qualitative data highlighted uncertainty amongst participants in terms of awareness and understanding of cellulitis, particularly their experiences of first episode cellulitis. We found: (1) low prior awareness of cellulitis, 2) uncertainty around diagnosis, 3) concern/surprise at the severity of cellulitis, 4) perceived insufficient information provision. Participants were surprised they had never heard of cellulitis and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this confusing. Two hundred and forty surveys were completed (response rate 17%). The quantitative data showed that, whilst many participants had received information on the treatment of cellulitis (60.0%, n=144), many reported receiving no information about causes (60.8%, n=146) or prevention of recurrence (73.3%, n=176).

Consequences

There is a need for provision of basic information for people with cellulitis, particularly (1) being informed of the name of their condition, (2) how to manage acute episodes, (3) how to reduce risk and prevent recurrence.