Community based treatment for chronic oedema: an effective service model

BACKGROUND: Chronic oedema care is patchy and of variable quality internationally. This study was undertaken to develop and evaluate a system of care that would provide for patients within a geographical area of London (Wandsworth), UK. METHODS AND RESULTS: A prospective cohort design with interve...

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Main Authors: Moffatt, Christine J., Doherty, Debra, Franks, Peter J., Mortimer, Peter
Format: Article
Published: Mary Anne Liebert 2017
Online Access:https://eprints.nottingham.ac.uk/46784/
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author Moffatt, Christine J.
Doherty, Debra
Franks, Peter J.
Mortimer, Peter
author_facet Moffatt, Christine J.
Doherty, Debra
Franks, Peter J.
Mortimer, Peter
author_sort Moffatt, Christine J.
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND: Chronic oedema care is patchy and of variable quality internationally. This study was undertaken to develop and evaluate a system of care that would provide for patients within a geographical area of London (Wandsworth), UK. METHODS AND RESULTS: A prospective cohort design with intervention of a new service design following a six month baseline period. Patients were identified through health professionals. A stratified random sample was drawn from all patients and an implementation strategy developed. Clinical assessment combined with questionnaires evaluated clinical, patient and health service outcomes at six monthly periods. In all, 312 patients were identified in community and acute services giving a crude ascertainment rate of 1.16 per 1,000 population. The random sample of 107 was mostly female (82%) with mean (SD) age of 72.9 (12.4) in men and 68.6 (15.0) years in women. Mean reductions in limb volume achieved statistical differences at 6-12 months after implementation (difference [d] =115 ml, p=0.0001). Incidence of cellulitis dropped from 41.5/ 100 patient years at baseline to zero at 6-12 months. Quality of life showed greatest improvements between baseline and 6 months post implementation, the largest differences being in role physical (d=32.7, p=0.0001) and role emotion (d=24.0, p<0.0001). Euroqol increased following implementation by a mean score of 0.05 (p=0.007). There was a in six monthly health care costs from £50171 per100 patients at baseline to £17618 between 6 and 12 months. CONCLUSIONS: This process of implementation improves health outcomes whilst reducing healthcare costs in patients with lymphoedema.
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spelling nottingham-467842024-08-15T15:23:38Z https://eprints.nottingham.ac.uk/46784/ Community based treatment for chronic oedema: an effective service model Moffatt, Christine J. Doherty, Debra Franks, Peter J. Mortimer, Peter BACKGROUND: Chronic oedema care is patchy and of variable quality internationally. This study was undertaken to develop and evaluate a system of care that would provide for patients within a geographical area of London (Wandsworth), UK. METHODS AND RESULTS: A prospective cohort design with intervention of a new service design following a six month baseline period. Patients were identified through health professionals. A stratified random sample was drawn from all patients and an implementation strategy developed. Clinical assessment combined with questionnaires evaluated clinical, patient and health service outcomes at six monthly periods. In all, 312 patients were identified in community and acute services giving a crude ascertainment rate of 1.16 per 1,000 population. The random sample of 107 was mostly female (82%) with mean (SD) age of 72.9 (12.4) in men and 68.6 (15.0) years in women. Mean reductions in limb volume achieved statistical differences at 6-12 months after implementation (difference [d] =115 ml, p=0.0001). Incidence of cellulitis dropped from 41.5/ 100 patient years at baseline to zero at 6-12 months. Quality of life showed greatest improvements between baseline and 6 months post implementation, the largest differences being in role physical (d=32.7, p=0.0001) and role emotion (d=24.0, p<0.0001). Euroqol increased following implementation by a mean score of 0.05 (p=0.007). There was a in six monthly health care costs from £50171 per100 patients at baseline to £17618 between 6 and 12 months. CONCLUSIONS: This process of implementation improves health outcomes whilst reducing healthcare costs in patients with lymphoedema. Mary Anne Liebert 2017-08-18 Article PeerReviewed Moffatt, Christine J., Doherty, Debra, Franks, Peter J. and Mortimer, Peter (2017) Community based treatment for chronic oedema: an effective service model. Lymphatic Research and Biology, 16 (1). pp. 92-99. ISSN 1557-8585 http://online.liebertpub.com/doi/abs/10.1089/lrb.2017.0021?journalCode=lrb doi:10.1089/lrb.2017.0021 doi:10.1089/lrb.2017.0021
spellingShingle Moffatt, Christine J.
Doherty, Debra
Franks, Peter J.
Mortimer, Peter
Community based treatment for chronic oedema: an effective service model
title Community based treatment for chronic oedema: an effective service model
title_full Community based treatment for chronic oedema: an effective service model
title_fullStr Community based treatment for chronic oedema: an effective service model
title_full_unstemmed Community based treatment for chronic oedema: an effective service model
title_short Community based treatment for chronic oedema: an effective service model
title_sort community based treatment for chronic oedema: an effective service model
url https://eprints.nottingham.ac.uk/46784/
https://eprints.nottingham.ac.uk/46784/
https://eprints.nottingham.ac.uk/46784/