Author: Andrea Mangion
Mangion, Andrea, 2024 Digital Health in Lymphoedema Care, Flinders University, College of Medicine and Public Health
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Background:
Lymphoedema is a chronic inflammatory condition affecting millions of people globally. The condition is characterised by the accumulation of fluid, fibrosis, and adipose tissue in areas of compromised lymphatic drainage. The condition results in swollen limbs, causing discomfort and distress, thereby significantly diminishing patients' quality of life. If left untreated, lymphoedema can lead to severe physical sequelae, including limb disfigurement and skin infections known as cellulitis. Traditional care is limited by its dependence on in-person visits which can hinder timely intervention and adequate treatment.
Given the profound impact of lymphoedema on patients' quality of life and the severe complications which can arise when left untreated, forms of innovative care which can enhance the care of this chronic condition are warranted. Digital health, which encompasses information and communication technologies delivered through electronic health (eHealth) modalities such as computer-based interventions, mobile health (mHealth), ubiquitous health (uHealth) and telehealth, provides an innovative approach to the care of this chronic condition.
The adoption of innovative telehealth solutions surged during the COVID-19 pandemic, enabling lymphoedema patients to continue receiving care despite enforced lockdowns. Prior to this period, telehealth and other eHealth modalities had been scarcely researched in the context of lymphoedema care.
Globally, there is a rapid and widespread adoption of eHealth modalities, extending beyond telehealth to include technologies such as robotics, wearable devices, health information systems, and applications of artificial intelligence. Additionally, uHealth technologies are emerging, with research increasingly focused on the continuous and personalised monitoring of individuals in their everyday lives. Despite these advancements in other health domains, the utilisation of digital health in lymphoedema care may be limited and may not have reached its full potential.
Method and results:
Research from 2021 to 2024 was conducted to address the question, "How is digital health being utilised in the prevention, diagnosis, assessment, and treatment of lymphoedema?" It was not known how many types of eHealth modalities were being used in lymphoedema care. It was also unclear whether contemporary challenges in digital health, such as issues of accessibility, appropriateness, and applicability, were affecting the adoption and use of digital health technologies in lymphoedema care.
Original and innovative research was undertaken finding eighteen eHealth modalities and exploring aspects of accessiblity, appropriateness and applicabilty. The unique contribution to research was a comprehensive description of how digital health interventions were being used in the prevention, diagnosis, assessment, and treatment of lymphoedema. Through sixteen publications and the development of five digital research prototypes this thesis represents a significant contribution to the understanding and application of digital health in lymphoedema care, addressing a critical gap in the existing literature.
Conclusion:
Digital health was utilised in various aspects across the prevention, diagnosis, assessment, and treatment of lymphoedema. Advanced eHealth modalities like robotics and applications of artificial intelligence were reported in research environments but were not yet fully integrated into clinical practice. Telehealth, despite its established presence, still faced adoption barriers. Issues related to accessibility, appropriateness, and applicability of digital health in lymphoedema care presented both challenges and opportunities. Digital health has yet to achieve its full potential in this field, underscoring the need for further research to fully harness its capabilities in lymphoedema care.
Keywords: Digital health, eHealth, mHealth, telehealth, lymphoedema, lymphedema, chronic oedema, edema, physiotherapy, robotics, artificial intelligence, AI, chatbot, patient-centred care, accessiblity, ChatGPT, Bard
Subject: Health Service Management thesis
Thesis type: Doctor of Philosophy
Completed: 2024
School: College of Medicine and Public Health
Supervisor: Professor Neil Piller