Lack of agreement over the international classification for compression therapy contributes to confusion over what measures are required to capture patient-reported and cost-effective outcomes of compression therapy for the heterogenous patient population. The medical device industry that manufactures compression products has important insights into these iissues, which have not been previously explored. This knowledge could provide clarity for improving the development of compression products and use of outcome measures internationally, which could improve access and uptake of compression. Eight medical device companies that produce compression products and have expertise in reimbursement took part in 11 individual semi-structured interviews to explore these issues. Data were analysed using interpretative phenomenological analysis. Five superordinate categories emerged: (1) no definition-status quo, (2) an ageing population, (3) evidence-based healthcare, (4) changing international markets and (5) patients as consumers. These were underpinned by 13 themes: (1) technical versus clinical descriptions of compression, (2) generic compression, (3) knowledge deficit throughout the system, (4) lack of evidence, (5) increasing healthcare pressures, (6) increased patient complexity, (7) healthcare systems, (8) inequality in healthcare, (9) beliefs and myths about compression, (10) lack of incentive for investment, (11) reimbursement barriers, (12) burden of patient cost and (13) increased choice and direct purchase. Reliance on technical definitions of compression, rather than clinical descriptions, lead to poor uptake of compression therapy in clinical practice and barriers to reimbursement. The medical device industry adopts national strategies for obtaining reimbursement, as the requirements for each country differ substantially. A range of outcome measures are urgently required.
Keywords: Chronic edema; Chronic oedema; Compression therapy; Delayed wound healing; Leg ulcers; Lymphedema; Lymphoedema; Wounds.