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Feasibility of implementing a remote system for lymphoedema conservative therapy: a case study

04 July 2024
Volume 33 · Issue 13

Abstract

Background:

Poor access to lymphoedema specialists and communication between them and patients prevents appropriate lymphoedema management. Therefore, development and dissemination of remote systems is necessary to improve care in rural areas with limited medical personnel or access to medical coordination.

Aims:

The authors evaluated the elements required for providing patient education on conservative therapy for lymphoedema, to determine the feasibility of remote management.

Methods:

The study involved connecting a health professional in a local clinic (point A) treating a patient with lymphoedema, who was present alongside the clinician, with a specialist certified lymphoedema therapist (CLT) located remotely in a university (point B).

Findings:

The CLT was able to greet, interview and provide guidance to the patient on conservative therapy. Direct contact with the patient was not possible, which limited visualisation, palpation, leg circumference measurement, and lymphatic drainage management.

Conclusion:

The findings suggest that remote a lymphoedema management approach involving conservative therapy benefits both patients and health professionals, particularly in rural regions. Future studies are needed to confirm the effectiveness of this approach to confirm adequate treatment.

The primary goal of lymphoedema management is the prevention of oedema exacerbation and cellulitis (International Lymphoedema Framework, 2006). The condition can be managed conservatively or surgically. For conservative treatment, complex decongestive therapy is recommended: this includes skin care, manual lymphatic drainage, compression therapy, exercise therapy and self-care instruction (International Lymphoedema Framework, 2006). These conservative techniques have been shown to be efficacious: improved outcomes include decreased oedema, decreased recurrence rate of cellulitis and improved quality of life (Li et al, 2016; Mendoza and Amsler, 2023; Webb et al, 2023). However, a survey of patients with lymphoedema in Japan and abroad found that the recurrence rate of cellulitis was as high as 50% (Dai et al, 2019), suggesting that lymphoedema management goals are not being met fully.

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