Quality of Care of Patients with Chronic Lymphoedema in Germany

Abstract

Background: The management of lymphoedema is complex and should be based on guidelines. To date, no data assessing quality of care in lymphoedema in Germany are available. Objective: We aimed at evaluating the quality of care of lymphoedema in the metropolitan area of Hamburg using guideline-based indicators. Methods: Cross-sectional, community-based study including patients with lymphoedema. Assessment included a structured interview, clinical examination and patient-reported outcomes. Quality indicators derived from guidelines by a Delphi consensus were applied. Results: 348 patients (median age 60.5 years) with lymphoedema (66.4%), lipoedema (9.5%) or combined oedema (24.1%) were included. 86.4% performed compression therapy, 85.6% received lymphatic drainage. On average 55.0% of the quality of care criteria were met; 64.8% were satisfied with care. The distribution curve of the health care index was almost normal. Treatment by specialists led to a higher quality of care index. Conclusion: Although overall quality of care in lymphoedema is fair, many patients are not treated properly according to guidelines.

Associations between the treatments and outcomes of patients with upper and lower lymphoedema in Japan: A cross-sectional observational study

“…In Germany, only 64.8% of patients were found to be satisfied with lymphoedema treatment, although 86.4% of the patients underwent compression therapy and 85.6% received lymphatic drainage (Herberger et al, 2013). Based on these results, it is necessary to develop new treatments in the future.…”

Validation of a short-form of the Freiburg Life Quality Assessment for lymphoedema (FLQA-LS) instrument

“…In this article we have published data in relation to the validation of the FLQA‐LS. However, other data obtained from questionnaires and personal interviews with the patients have been analysed and have been or will be published in separate papers …”

“…Community‐based studies have shown a high patient need for treatment and health care . However, in Germany, like in many countries, patients with chronic lymphoedema receive only a moderate level of health care . In particular, early diagnosis and treatment are frequently missed …”

Quality of life in patients with primary and secondary lymphedema in the community

“…Recent data support early treatment of lymphedema by demonstrating a positive effect of efficient lymphedema treatment on quality of life . Specific lymph therapy has been shown to increase the quality of care in the community …”

“…Furthermore, complications such as erysipelas and chronic ulceration may arise . Health care studies in Germany have demonstrated that the quality of care is largely inadequate …”