{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:08:42Z","timestamp":1767337722744,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005646","name":"Actelion Pharmaceuticals","doi-asserted-by":"publisher","award":["Unrestricted educational grant"],"award-info":[{"award-number":["Unrestricted educational grant"]}],"id":[{"id":"10.13039\/100005646","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Digital ulcers (DU) remain one of the most burdensome co\u2010morbidities in systemic sclerosis. The objectives of the study were to describe patient\u2010level stratification and to evaluate a nurse\u2010led DU clinic service development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nurse\u2010led digital ulcer clinic was established to identify patients with DU and manage them. Patients were recruited through scleroderma clinics, GP referrals, and self\u2010referrals. The clinic involved patients being treated with appropriate treatment. Patients were stratified according to their DU risk level based on number and severity of ulcers. Among these, 22 patients were asked to complete a patient satisfaction survey. Data were analyzed descriptively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010five patients were seen in the clinic, 46 (61%) were 56 years of age and above. Patients were identified as high (23%), medium (51%) or low risk (26%) for development of DU. The duration of DU history was from 7 months to 40 years. Prior to attending the nurse\u2010led DU clinic, 90% of patients had received up to six courses of antibiotics for their DU, 76% had attended A&amp;amp;E, and 90% had unscheduled appointments. 90% had been seen by the GP due to DU and subsequently required hospital admissions. During the nurse\u2010led clinic follow\u2010up, only two patients had emergency admission. All patients reported that their needs in personal care of DU were met.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are a significant number of people with SSc who have DUs affecting their quality of life as well as needing more healthcare services. A dedicated specialist nurse\u2010led DU clinic may improve overall care of patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1433","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T21:15:20Z","timestamp":1579641320000},"page":"92-97","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Improving access to digital ulcer care through nurse\u2010led clinic: a service evaluation"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6922-6970","authenticated-orcid":false,"given":"Tanaka","family":"Ngcozana","sequence":"first","affiliation":[{"name":"Rheumatology Department Royal Free NHS Foundation Trust  Pond Street London NW3 2QG UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Voon H.","family":"Ong","sequence":"additional","affiliation":[{"name":"Rheumatology Department Royal Free NHS Foundation Trust  Pond Street London NW3 2QG UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Denton","sequence":"additional","affiliation":[{"name":"Rheumatology Department Royal Free NHS Foundation Trust  Pond Street London NW3 2QG UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"Allcock R. J. Forrest I. Corris P. A. Crook P. R. &Griffiths I. D.(2004).A study of the prevalence of systemic sclerosis in northeast England. Rheumatology (Oxford) 43 (5) 596\u2010602. doi.org\/10.1093\/rheumatology\/keh124.","DOI":"10.1093\/rheumatology\/keh124"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq097"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew224"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200631"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker269"},{"key":"e_1_2_10_7_1","unstructured":"NHS England. (2015).Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis: NHS England [Available from:https:\/\/www.engage.england.nhs.uk\/consultation\/specialised-services-policies\/user_uploads\/bosntn-sildnfl-syst-sclerosis-pol.pdf"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2013.780095"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.02.005"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-009-8193-3"},{"issue":"2","key":"e_1_2_10_11_1","first-page":"71","article-title":"Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry","volume":"31","author":"Guillevin L.","year":"2013","journal-title":"Clinical and Experimental Rheumatology"},{"issue":"12","key":"e_1_2_10_12_1","first-page":"2423","article-title":"Natural history of ischemic digital ulcers in systemic sclerosis: single\u2010centre retrospective longitudinal study","volume":"34","author":"Hachulla E.","year":"2007","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew047"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20684"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20336"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20676"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.096677"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208121"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130900"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094193"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.072686"},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","unstructured":"Steen V. Denton C. P. Pope J. E. &Matucci\u2010Cerinic M.(2009).Digital ulcers: overt vascular disease in systemic sclerosis. Rheumatology (Oxford) 48 Suppl3 iii19\u201024.https:\/\/doi.org\/10.1093\/rheumatology\/kep105","DOI":"10.1093\/rheumatology\/kep105"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.062901"},{"issue":"6","key":"e_1_2_10_24_1","article-title":"The impact of magnetic resonance imaging in early diagnosis of hand osteomyelitis in patients with systemic sclerosis","volume":"32","author":"Zhou A.Y.","year":"2014","journal-title":"Clinical and Experimental Rheumatology"}],"container-title":["Musculoskeletal Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmsc.1433","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.1433","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/msc.1433","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.1433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T04:36:15Z","timestamp":1694061375000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/msc.1433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,21]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/msc.1433"],"URL":"https:\/\/doi.org\/10.1002\/msc.1433","archive":["Portico"],"relation":{},"ISSN":["1478-2189","1557-0681"],"issn-type":[{"type":"print","value":"1478-2189"},{"type":"electronic","value":"1557-0681"}],"subject":[],"published":{"date-parts":[[2020,1,21]]},"assertion":[{"value":"2019-08-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}