P-85 Half the community nurse case load!: estimating the prevalence of lower limb chronic oedema

Abstract

Background Chronic oedema has a profound impact on quality of life. It may originate from primary anatomical reasons (primary lymphoedema), be secondary to cardio-vascular dysfunction, be related to cancer or cancer treatments and is increasingly a result of obesity. The numbers of patients with chronic oedema are increasing and both hospice specialist lymphoedema and community nursing teams are over-stretched with ‘revolving door referrals. The prevalence and burden of illness and impact on care services in the UK is unknown. Aims To determine the scale and impact of lower limb chronic oedema and wounds within Leicester City. To inform the development of an integrated community chronic oedema pathway Method Quantitative data was collected by community nurses following a period of training by the specialist hospice lymphoedema team. Each patient on a community nurse caseload was clinically assessed for chronic oedema and wounds and the results were recorded on a questionnaire. Data validation was undertaken by a specialist lymphoedema nurse on a random sample of 20 patients establishing a high level of agreement between raters. Results 1,308 patients were assessed. 43% had chronic oedema defined by swelling and/or skin changes. 45% of these patients had an associated wound such as venous ulcer. Risk factor analysis is being undertaken comparing those with and without oedema. Conclusion The prevalence of chronic oedema in the community nursing caseload is very high. The totality of the clinical care requirements for these patients were often unrecognised and dressings addressed as a ‘task’ in isolation of a clear management strategy.