Prospective monitoring and early detection of subclinical lymphoedema can prevent its progression. Whilst it is standard practice at Royal Brisbane and Women’s Hospital (RBWH) to offer patients group lymphoedema risk minimisation education and individualised assessment following axillary dissection (AD) surgery, many have difficulty attending these appointments in-person. Telehealth (TH) may be an effective alternative model to deliver this service.
In this pilot cohort study, patients following AD surgery attended a group or 1:1 lymphoedema education and individualised monitoring session via eHAB® (web-based TH system) or in-person (usual care (UC)) with their physiotherapist. Outcomes relating to patient attendance, patient and clinician satisfaction and costs were recorded. This study is embedded within a larger clinical trial comparing TH and in-person care service models.
The planned accrual target was reached with 55 individuals participating in this study, and 27 electing to be in the TH group. There were no significant differences between participant characteristics in the two groups. 91% of participants attended their appointments, including all participants who nominated for the UC program. All participants reported high overall satisfaction, with ≥90% completely agreeing or agreeing with statements regarding access, cost and waiting time for treatment. Clinicians also reported high satisfaction for delivery of TH education and reviews. TH participants saved on average $63 (+/- $54) per appointment through avoided travel (mean distance = 62 km +/- 79km return) to RBWH. More in depth cost analysis is planned.
The use of TH to provide convenient options for provision of lymphoedema education and follow up was associated with good attendance, high levels of participant and clinician satisfaction and favourable participant cost savings. Further evaluation is required to explore the broader impact of this potentially valuable and timely service as an alternative model compared to traditional lymphoedema education and monitoring approaches.