Effectiveness of a Home-based Head and Neck Lymphedema Management Program: A Pilot Study.
OBJECTIVE
This study aimed to compare outcomes in patients with head and neck lymphedema receiving either a home-based lymphedema treatment program or a hybrid approach including both home-based treatment and regular clinical visits.


METHODS
Outcomes were assessed in patients receiving head and neck lymphedema rehabilitation. Baseline measures of neck, submental, and facial edema were obtained and repeated following treatment. A home program was recommended for all patients, and those receiving hybrid care received the same recommendations as well as a visit with the lymphedema therapist for additional treatment. Their outcomes were compared using standard statistical analysis.


RESULTS
Fifty consecutive individuals were included, 25 in each group. Adherence to at least 50% of recommended treatment was reported in 68% of those receiving home-based treatment and 84% of those receiving hybrid care. Significant improvement was demonstrated for 66% of patients. There was no statistically significant difference between treatment groups with regard to clinically significant improvement (P = .15). Patients receiving hybrid therapy demonstrated treatment advantages regarding facial edema (P = .037). Adherence to treatment was associated with clinical improvement (P = .047).


CONCLUSIONS
Comparable benefits were observed regardless of whether patients had a home-based or hybrid lymphedema treatment approach. These data suggest a home-based treatment approach may be appropriate for patients unable to participate in clinical sessions. However, for patients with significant facial edema, a hybrid approach may be preferable. Adherence was associated with better outcomes. Given these findings, future investigations should consider strategies to improve adherence to optimize the outcomes lymphedema treatment.


LEVEL OF EVIDENCE
3b Laryngoscope, 2020.
['Yao|Theresa|T|', 'Beadle|Beth|B|', 'Holsinger|C Floyd|CF|0000-0002-9594-1414', 'Starmer|Heather M|HM|0000-0002-1716-9852']
D000328:Adult D000368:Aged D005260:Female D006257:Head D006699:Home Care Services D006801:Humans D008209:Lymphedema D008297:Male D008875:Middle Aged D009333:Neck D010865:Pilot Projects D015397:Program Evaluation D012189:Retrospective Studies D016896:Treatment Outcome
head and neck lymphedema home-based treatment adherence Head and neck cancer lymphedema therapy