Co-designing an optimal provision process for assistive products to support donning and doffing of compression hosiery

Introduction: This study aimed to optimise the provision process of assistive products for donning and doffing (APD) to ensure that every wearer of compression hosiery (CH) receives the most suitable APD and appropriate support to achieve independence. Methods: Using an experience-based co-design approach, the study was conducted in two phases. In the discovery phase, bottlenecks in APD provision were identified based on four previous studies examining experiences with CH and APD. In the co-design phase, a Quality Improvement Group (QIG) of 11 representatives of interested parties (2 patients, 8 care professionals, and 1 health insurer) collaboratively developed, across 6 meetings, principles and solutions for an optimal APD provision process, guided by the Generic Quality Framework Care for Assistive Products. Results: Consensus was reached on an optimal APD provision process based on four core principles: (1) treatment should be provided by a single healthcare professional whenever possible; (2) assistance should only be provided when independent donning and doffing are not achievable, even with an APD; (3) device provision should be guided by patient functioning rather than diagnosis; and (4) stepped care should guide APD selection, with the compression therapist assuming an expanded role in assessment, training, and follow-up. Conclusion: To support this revised process, compression therapists require additional training and reimbursement structures must be adapted.