Quality of care of patients with chronic lymphoedema in Germany

Dermatology. 2013;226(3):238-46. doi: 10.1159/000349988. Epub 2013 Jul 2.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Community Networks / standards*
  • Cross-Sectional Studies
  • Delphi Technique
  • Dermatology
  • Drainage
  • Female
  • General Practice
  • Germany
  • Guideline Adherence
  • Gynecology
  • Humans
  • Internal Medicine
  • Lymphedema / diagnosis
  • Lymphedema / therapy*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Practice Guidelines as Topic
  • Quality Indicators, Health Care*
  • Quality of Life*
  • Stockings, Compression
  • Surveys and Questionnaires
  • Young Adult