Lymphoedema: an underestimated health problem.

Franks, P.J.; Doherty, D.C.; Williams, A.F.; Jeffs, E.; Bosanquet, N.; Mortimer, P.S.; Moffatt, Christine; Badger, C

Abstract

Background: Lymphoedema/chronic oedema is an important cause of morbidity in the population, but little is known of its epidemiology and impact on patients or health services.

Aim: To determine the magnitude of the problem of chronic oedema in the community, and the likely impact of oedema on use of health resources, employment and patient’s quality of life.

Design: Questionnaire-based survey.

Methods: Health professionals from dedicated lymphoedema services, specific out-patient clinics, hospital wards and community services (GP clinics and district nurses) were contacted to provide information on patients from within South West London Community Trust. A subset of the identified patients was interviewed.

Results: Within the catchment area, 823 patients had chronic oedema (crude prevalence 1.33/1000). Prevalence increased with age (5.4/1000 in those aged > 65 years), and was higher in women (2.15 vs. 0.47/1000). Only 529 (64%) were receiving treatment, despite two specialist lymphoedema clinics within the catchment area. Of 228 patients interviewed, 78% had oedema lasting > 1 year. Over the previous year, 64/218 (29%) had had an acute infection in the affected area, 17/64 (27%) being admitted for intravenous antibiotics. Mean length of stay for this condition was 12 days, estimated mean cost £2300. Oedema caused time off work in > 80%, and affected employment status in 9%. Quality of life was below normal, with 50% experiencing pain or discomfort from their oedema.

Discussion: Chronic oedema is a common problem in the community with at least 100 000 patients suffering in the UK alone, a problem poorly recognized by health professionals. Lymphoedema arising for reasons other than cancer treatment is much more prevalent than generally perceived, yet resources for treatment are mainly cancer-based, leading to inequalities of care.

Citation

Mortimer, P., Franks, P., Doherty, D., Williams, A., Jeffs, E., Bosanquet, N., Moffatt, C., & Badger, C. (2003). Lymphoedema: an underestimated health problem. QJM: An International Journal of Medicine, 96(10), 731-873. https://doi.org/10.1093/qjmed/hcg126

• Journal Article Type: Article
• Online Publication Date: Sep 18, 2003
• Publication Date: Oct 1, 2003
• Deposit Date: Apr 16, 2008
• Print ISSN: 1460-2725
• Electronic ISSN: 1460-2393
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 96
• Issue: 10
• Pages: 731-873
• DOI: https://doi.org/10.1093/qjmed/hcg126
• Keywords: Lymphoedema/chronic oedema; Inequalities of care; Cancer treatment
• Public URL: http://researchrepository.napier.ac.uk/id/eprint/1596
• Publisher URL: http://dx.doi.org/10.1093/qjmed/hcg126