THE IRISH MEDICAL TIMES SURVEY
In the Spring Newsletter we reported that we were, in conjunction
with the Irish Medical Times, embarking on a phone in of a random
selection of 100 GP’s and asking them questions about Lymphoedema.
You will be interested to read the results.
Sandra Ryan from the Irish Medical Times examines the statistics and
comes up with some surprising results, which we reproduce in detail.
A new Irish Medical Times survey has revealed that 21 per cent of
GPs are not familiar with lymphoedema.
‘Severe lack of awareness, interest and expertise in profession
onLymphoedema’
IMT carried out the telephone survey in conjunction with the Irish
Lymphoedema Support Network (ILSN).
We asked 100 GPs a number of questions about the condition, to
determine whether it is diagnosed and treated appropriately in
Ireland.
The survey questioned 100 GPs. Of these, 36 were from mostly rural
areas, seven were from Galway, 18 from Cork and 39 from Dublin. The
survey revealed that just 18 per cent of the doctors said they were
“very familiar”’ with lymphoedema, two-thirds said they were
“familiar”
with the condition, and 21 per cent were “not at all familiar”.
While the majority of the doctors were aware of primary and
secondary
lymphoedema (86 per cent) most (69 per cent) also said they had not
diagnosed any patients with the condition in the last six months.
The majority of GPs who were familiar with both primary and
secondary
lymphoedema of the condition were from the country. Six GPs in
Dublin were familiar with both as were two from Cork.
Just 30 per cent of all GPs surveyed have diagnosed lymphoedema in a
patient in the last six months.
The majority of these doctors were from Dublin (11 out of the 39
from
Dublin surveyed.)
The survey shows that three-quarters of all the GPs have less than
five
patients with primary lymphoedema. However, 41 per cent have more
than
five patients with secondary lymphoedema.
This indicates that secondary lymphoedema, often caused by cancer,
is more common.
Over two-thirds of all GPs surveyed had no patients with lymphoedema
while one per cent were not sure. Just over 40 per cent have more
than five
patients with either primary or secondary lymphoedema.
Forty per cent of the doctors were not aware of the Manual Lymph
Drainage
(MLD) treatment recommended for lymphoedema. Sixty per cent were
aware of MLD, but some of these said it was not available in their
area.
A GP in Clare said that MLD was not available, and a GP in Cavan
told IMT
that it would take an hour and a half for the patient to get to a
treatment centre.
Almost 70 per cent said they do not refer patients for MLD
treatment. Of
those who do refer, 27 per cent send the patient to their local
hospital,
20 per cent to a vascular surgeon, eight per cent refer to a
physician,
and just five per cent refer patients to an MLD therapist and nine
per
cent to a physiotherapist.
The majority of GPs who do refer patients were from the rural areas.
Just
one GP from Galway said he refers the patients on for treatment.
Just over one in ten GPs said they were unsure about referring
patients
for MLD. For example, a GP in the West said he was “not happy” with
the MLD treatment available for lymphoedema, and another doctor said
he was not convinced that it is the best form of treatment for the
condition.
Many doctors mentioned MLD availability problems, especially in
Clare, parts of Dublin and Cavan.
Sufferers of lymphoedema are entitled to two free pairs of
compression
hosiery from their health board a year.
Ms. Derville Phillips, chairperson of the ILSN, describes this as
totally
inadequate, and said the hosiery is the only help they have received
from
the Government to assist Lymphoedema patients in the last nine
years.
Most GPs were not aware of the free hosiery offer.
Seventy-two per cent of GPs were not aware of the free hosiery
offer. Of
those who were, 13 were from Dublin and 13 from elsewhere in the
country.
Two GPs from Galway knew about the free hosiery, as did three from
Cork.
Many doctors told IMT that two pairs were “totally inadequate”.
A Tipperary GP said that she has a lymphoedema patient who was
refused the free hosiery from the health board.
This GP’s patient was asked to fill out a hardship disability form
to get
the hosiery, which the GP said was insulting.Another GP reported a
similar situation for one of their patients.
The final question related to the Network. More than three-quarters
of the GPs had not heard of the support group.
The ILSN is a voluntary organisation which campaigns for provision
of
treatment for sufferers and aims to promote awareness amongst the
medical profession.
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The Irish Lymphoedema Support Network (ILSN), says there is a severe
lack of awareness, interest and expertise among the medical
profession about the condition.
There are two types of lymphoedema: primary (a congenital lymphatic
deformity) and secondary (caused by damage to the lymphatic
structures by
cancer treatment, surgery, infection, tumour, inflammation, or any
condition which compromises the lymphatic system).
Many Irish sufferers have had to travel abroad for the correct
treatment. Support group chairperson,
Ms Derville Phillips, told IMT that
many patients have travelled to Germany for health board arranged
treatment, remaining there for eight weeks.
If they don’t go abroad, the option is to pay up to €3,000 for
treatment at home.
ILSN have made a submission to a working group on medical education
stating that there is a lack of awareness.
“Most lymphoedema sufferers have encountered unbelievable obstacles
in
their quest for diagnosis and subsequent effective treatment,” says
the ILSN.
“There appears to be inadequate emphasis on the pathology of this
condition within the undergraduate syllabus.”
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This research was carried out by Irish Medical Times, in association
with
the Irish Lymphoedema Support Network, and was supported by Royale
Distributing Agency, distributors/agency for compression hosiery
(MEDI,
Lastex, Duomed & Ibici Compression Stockings).