LYR study: Influence of a web-based application on the systematic chronological and effectiveness of network-guided patient management processes in lymphological care

Summary

The systematic acquisition of data for proving the benefit of standard treatment, demonstrating the efficiency of treatment provided by interprofessional patient management processes and providing valid epidemiological data is inadequate or even nonexistent in the treatment of lymphological disorders. The LYR study firstly uses a webbased documentation tool to examine whether treatment quality is ensured under the conditions provided by an outpatient lymph network that has been guaranteed by a systematic and guideline-compliant treatment analogy. The study evaluated the introduction and handling of a web-based documentation platform for joint case management. LYR also stands synonymously for Lymph Register, and represents a feasibility study with regard to establishing a national lymph register. A phase 1 multicentre interventional study of complex physical decongestion therapy on 61 subjects with different lymphological disorders investigated the immediate and late effects of a prespecified treatment analogy and web-based data acquisition with interdisciplinary data access in six regional lymph networks. Findings on the changes to quality of life and on the effect of the frequency of manual lymphatic drainage and the height of lymphological compression bandages on the results of decongestion were documented and data on prescribing periods and the behaviour of cost bearers were acquired. The study results show that a web-based, structured documentation system can usefully support treatment regimens and simplify mutual access to the patient management process. The epidemiological data acquired during the evaluation of the findings sheet are completely new in Germany and are seen as a feasibility study for a national lymph register that is being prepared. LYR also shows that standard treatment (CPD) has positive effects on circumferences, quality of life, and mobility. It was also shown that a high frequency of manual lymph drainage shortened the decongestion treatment period.

Keywords

Lymph networks - lymphoedema registry study - network-guided patient management - web-based medical documentation

• References

• 1 Finnane A, Janda M, Hays SC. Review of the evidence of lymphoedema treatment effect. Am J Phys Med Rehabhil 2015; 94 (06) 483-498.
• 2 Foeldi E. Therapie des Lymphödems. Der Hautarzt 2012; 63 (08) 627-633.
• 3 Leitlinie der Gesellschaft Deutschsprachiger Lymphologen. Diagnostik und Therapie der Lymphödeme. AWMF-Leitlinien Register: Nr. 058/001.
• 4 Bundesärztekammer, (Muster-)Weiterbildungs-ordnung 2003 in der Fassung vom. 28.06.2013.
• 5 Anlage 3 vom17. Januar 2005 zu den Rahmenempfehlungen nach §125 Abs. 1 SGB V vom 1. August 2001: Anforderungen an die Abgabe und Abrechnung von besonderen Maßnahmen in der Physiotherapie.
• 6 Anforderungen an die Fortbildung der Leistung - serbringer gemäß Empfehlung des GKV-Spitzenverbandes in der Fassung vom 15.09.2015. Kriterienkatalog in Anlehnung an §126 Abs. 1 Satz 3 SGB V.
• 7 Püschmann H, Haferkamp G, Scheppokat K-D, Vinz H, Wegner M. Vollständigkeit und Qualität der ärztlichen Dokumentation in Krankenakten: Untersuchung zu Krankenunterlagen aus Chirurgie, Orthopädie, Innerer Medizin und Neurologie. Dtsch Arztebl. 2006 103. 03 A-121 / B-104 / C-104.
• 8 Stockmann R. Einführung zu Funktionen und Methoden von Evaluationsverfahren. Centrum für Evaluation. 2004 CEval-Arbeitspapier.
• 9 Moffatt C, Keast D, Towers A. LIMPRINT: An international multi-site population-based study to determine the prevalence and functional impact of lymphoedema/chronic oedema in the adult population of member countries of the International Lymphoedema Framework, Präsentation bei CAMPUS LYMPHOLOGICUM. 2015
• 10 G-BA-Richtlinie über die Verordnung von Hilfsmitteln. https://www.g-ba.de/downloads/62–492–934/HilfsM-RL_2014–07–17.pdf
• 11 Leung EY, Tirlapur SA, Meads C. The management of secondary lower limb lymphoedema in cancer patients: a systematic review. Palliat Med 2015; 29 (02) 112-119.