Lymphedema patients saw a nearly 80 percent reduction in their cellulitis episodes just by using an advanced pneumatic compression device at home, according to a study in JAMA Dermatology co-authored by Vanderbilt University School of Nursing Professor Sheila Ridner, PhD, MSHSA, FAAN, Pinar Karaca-Mandic, PhD, and Alan Hirsch, MD, from University of Minnesota and Stanley Rockson, MD, from Stanford School of Medicine.
The reduction in episodes also led to a 37 percent reduction in lymphedema-related healthcare costs for study participants, Ridner said of those using the Flexitouch® System by Tactile Medical, headquartered in Minneapolis, Minn. The Flexitouch System, a treatment used by patients at home, inflates over swollen areas of the limb or trunk to facilitate the movement of excess fluid out of the affected areas. Participants were divided into two subgroups – those with and without cancer-related lymphedema. Patients in each group experienced a dramatic 79 percent and 75 percent reduction in the rate of cellulitis episodes, respectively.
“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.”
“Healthy lymphatic vessels are – very simply and without controversy – essential to good health. By studying a very large group of patients offered this modern treatment, delivered within the patient’s own home, and then carefully measuring the impact, we were extremely gratified that these skin infections were lowered by nearly 80 percent within one year,” said Alan T. Hirsch, MD, director of the Vascular Medicine Program at the University of Minnesota Medical School and chief medical officer of Tactile Medical. “A device used at home can provide amazing reduction – for the patient and for the nation – of these skin infections, associated morbidity and cost. This is the very definition of a public health success.”
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 and psychological stress. Left untreated, this tissue swelling can be painful and is often associated with a loss of function, high risk of infection, and lower quality 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. It is estimated that as many as 250 million worldwide are affected by lymphedema.
This study analyzed 718 lymphedema patients who received care at sites across the United States over a five-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, which 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, patients experienced a reduction in outpatient hospital and physical therapy visits which significantly lowered their health care costs.
Among study participants with cancer, cellulitis episodes were reduced from 21.1 percent to just 4.5 percent – a 79 percent reduction in the rate of cellulitis episodes. Among non-cancer participants, cellulitis episodes were reduced from 28.8 percent to 7.3 percent – a 75 percent reduction in the rate of cellulitis episodes. Lymphedema-related physical therapy and outpatient visits were also both reduced, resulting in a 37 percent decrease in lymphedema-related costs, excluding medical equipment, per patient among those with cancer, and a 36 percent decrease in costs for the non-cancer 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 U.S. health insurer of more than 34 million individuals, the authors measured the impact of an advanced pneumatic compression device (the Flexitouch® System, Tactile Medical™, Minneapolis, MN) or “APCD” on health outcomes and health care costs.
