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Development and use of guideline-derived quality indicators for community lymphoedema


  • Funding sources
    The study was supported by medi Bayreuth, Germany.

  • Conflict of interest
    Katharina Herberger has no conflict of interest.

  • Christine Blome has received honoraria and travel expenses from medi Bayreuth.

  • Matthias Augustin has received a research grant from medi Bayreuth.

K. Herberger. E-mail:


Background  Treatment of lymphoedema is complex and needs specific skills. There are no standards for the evaluation of quality of care.

Objective  Development and application of indicators for the measurement of quality of care in lymphoedema.

Methods  In a three-step process including a national Delphi expert consensus, quality indicators were derived from national and international guidelines. In a cross-sectional study involving a large spectrum of care providers, the quality of lymphoedema care in the community was assessed by transforming the indicators to one unweighted quality index (QI).

Results  A total of 12 quality indicators were identified and applied to n = 348 patients with lymphoedema and lipolymphoedema of any origin in the metropolitan area of Hamburg (90.8% female, mean age 57, SD 14.5 years). On average, 55% of the quality indicators were met, and 64.8% of the patients were satisfied with lymphoedema care. There was a significant correlation between QI and satisfaction.

Conclusions  The quality indicators and the QI are feasible and valid for the evaluation of quality of care. They can support optimizing lymphoedema care.