Community-Based Treatment for Chronic Edema: An Effective Service Model
| Autor: | Peter S. Mortimer, Debra C. Doherty, Peter Franks, Christine Moffatt |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Quality Assurance Health Care education System of care Health outcomes 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) London Medicine Humans Lymphedema Prospective Studies Intensive care medicine Aged Community based Aged 80 and over business.industry Disease Management Health Care Costs Middle Aged medicine.disease Service model Chronic edema 030220 oncology & carcinogenesis Chronic Disease Physical therapy Quality of Life Female Cardiology and Cardiovascular Medicine business Delivery of Health Care |
| Zdroj: | Lymphatic research and biology. 16(1) |
| ISSN: | 1557-8585 1539-6851 |
| Popis: | 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. \ud 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. \ud 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 |
| Databáze: | OpenAIRE |
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