Advanced Device Improves Health and Costs for Patients With Lymphedema

Lymphedema patients experienced a nearly 80% reduction in their cellulitis episodes just by using an advanced pneumatic compression device (APCD) at home, according to a study in JAMA Dermatology (2015; doi:10.1001/jamadermatol.2015.1895).

The reduction in episodes also led to a 37% reduction in lymphedema-related health care costs for study participants, said coauthor Sheila Ridner, PhD, MSHSA, FAAN, professor at the Vanderbilt University School of Nursing in Nashville, Tennessee. She coauthored the paper with University of Minnesota School of Public Health Associate Professor Pinar Karaca-Mandic, PhD, in Minneapolis.

"This could be a game-changer in the area of lymphedema care," said Ridner. "Up to 10 million people in the United States are living and oftentimes suffering with symptoms of lymphedema. The idea that a home advanced pneumatic compression device can provide relief, decrease the number of cellulitis episodes and save money is an important new option for patients."

Lymphedema is an accumulation of fluid in tissues commonly caused by abnormalities in the lymphatic system or removal or damage to a person's lymph nodes. Symptoms include swelling, recurrent cellulitis, loss of physical function, psychological stress, and diminished qualify of life. Lymphedema cannot be cured and is typically managed through combined therapies of manual lymph drainage, multilayer bandaging, decongestive exercise, skin care, and long-term self-management.

This study analyzed 718 lymphedema patients who received care at sites across the United States over a 5-year period (2007-2013), and evaluated event rates and costs for a 12-month period prior to and a 12-month period after treatment. After receiving a device, patients experienced a reduction in outpatient hospital and physical therapy visits that significantly lowered their health care costs.

Among study participants with cancer, cellulitis episodes were reduced from 21.1% to just 4.5%, which was a 79% reduction in the rate of cellulitis episodes. Among noncancer participants, cellulitis episodes were reduced from 28.8% to 7.3%, a 75% reduction in the rate of cellulitis episodes. Lymphedema-related physical therapy and outpatient visits were also both reduced, resulting in a 37% decrease in lymphedema-related costs, excluding medical equipment, per patient among those with cancer, and a 36% decrease in costs in the noncancer cohort.

"Patients with lymphedema turn to dermatologists, primary care, and vascular physicians for treatment, and now these providers have a therapy to improve skin, limb, and systemic health for these individuals," said Jerry Mattys, CEO of Tactile Medical.

This study represents the largest investigation ever performed to define the impact of a single lymphedema treatment device in a national population. Using de-identified data from a large US health insurer of more than 34 million people, the authors measured the impact of the Flexitouch System, an APCD from Tactile Medical (Minneapolis, Minnesota) on health outcomes and health care costs. The device sequentially inflates over areas of the body affected by lymphedema to facilitate the movement of excess fluid from the limb back to the cardiovascular system.

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