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    Impact of a primary care lymphoedema service on cellulitis: audit and evaluation of economic implications in relation to diagnosis and history of cancer treatment.

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    Date
    2016
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    (2016) Impact of a primary care lymphoedema service on cellulitis: audit and evaluation of economic implications in relation to diagnosis and history of cancer treatment., no. 29.
    Abstract
    Question: what is the impact of a primary care lymphoedema service on cellulitis in relation to diagnosis and history of cancer? Design: A quantitative service evaluation with a retrospective, before and after study design. Participants: A total of 268 participants, taking part in the Lothian Primary Lymphoedema Service having experienced at least one episode of cellulitis. Intervention: Normal individualised treatment for lymphoedema including advice, education, exercises, manual therapy, compression therapy, psychosocial support, diet advice or and referral to weight management. Outcome measures: Limb Volume Pre- and Post-Treatment, measured using the tape measure method. Results: The 90 participants without a cancer diagnosis had a significantly higher pre-treatment limb volume (10195.06 ml (SD 4623.599) than the 42 participants with a previous cancer diagnosis (7922.18 ml (SD 5282.502) (95% CI 483.115 to 4062.465) .The groups did not differ significantly in their response to treatment. Participants with primary lymphoedema correlate negatively with a medium strength relationship for change in limb volume (Rp-bs= -.297) (95% CI -496 to 109). No other diagnosis had a statistically significant correlation with change in limb volume following treatment. Conclusion: Patient diagnosis and history of cancer affects their final outcome from the service. All secondary diagnoses correlate positively, if not significantly, with change in limb volume. Both cancer and non-cancer groups respond equally well to treatment. Patients with a cancer history have a significantly lower limb volume both entering the service and following treatment. Further longitudinal studies are required to investigate the effect diagnosis and early access to treatment have on patient outcome.
    URI
    https://eresearch.qmu.ac.uk/handle/20.500.12289/8582
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