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Background: Little is known about the treatment of oedema in palliative care patients. Aim: To outline the assessment, goals, and interventions for patients with oedema. Method: A 6-month chart review of a specialist physiotherapy-led oedema service was carried out. Results: Of the sample group (n=63), 28.6% of patients had lymphoedema, 15.9% had non-lymphatic oedema, 46% had mixed oedema and 9.8% had lymphorrhoea; 58 patients (92%) had cancer. The most common interventions were providing education (100%, n=63), using compression garments (58%, n=37), bandaging (51%, n=32), exercise (38%, n=24), lymphatic massage and kinesio-taping (35%, n=22 each). Treatment regime differed depending on the type of oedema present. Treatment goals were pragmatic: the most common were to maintain skin quality (54%, n=34), reduce limb volume (52%, n=32), and improve quality of life (48%, n=30). Conclusion: Palliative care oedema can be treated using manual methods, including compression and massage. Goals differ from other oedema populations. Research is hampered by lack of suitable measures to record skin changes and quality of life. [ABSTRACT FROM AUTHOR]

Background: elastic compression stockings (ECS) can be used as a non-pharmacological therapeutic option for older patients with orthostatic hypotension (OH). We aimed to investigate the practices and views of patients and physicians regarding the use of ECS for OH.Methods: two surveys were designed. The first was sent to 90 patients known to have been prescribed ECS for OH. This questionnaire included items related to the frequency of use and issues related to non-compliance. The second was sent to 69 consultant physicians in geriatric medicine. This included items related to prescribing practices and perceived patient compliance.Results: sixty-seven patients responded (response rate, 74%) and of those 64% were female. Mean age (SD) was 75.1 years (10.5), range 45–91 years. Thirty-three per cent wore ECS daily, whereas 43% never used them. Over half (51%) of the patients reported difficulty in application and 31% reported discomfort. Those aged 75 or older were more likely to report difficulty in application (P = 0.003). Forty-eight physicians responded (response rate, 70%). Eighty-nine per cent prescribe ECS for OH. There were significant differences between the frequency of use reported by patients and predicted by physicians (P < 0.001), with physicians less likely to predict daily or non-use. Eighty-nine per cent of physicians predicted that difficulty in application was the main reason for non-compliance.Conclusion: although prescribed frequently, the use of ECS in patients with OH is often limited by issues related to practicality. Physicians correctly predicted the main reasons for non-compliance although underestimated the scale of patient compliance with ECS. [ABSTRACT FROM PUBLISHER]

Background: Elastic compression stockings (ECS) can be used as a non-pharmacological therapeutic option for older patients with orthostatic hypotension (OH). The aims of our study were to investigate the practices and perceptions of patients and physicians regarding the use of ECS for OH.Sampling methods: Two surveys were designed and piloted. The first was sent to 90 patients randomly sampled from department syncope department. This questionnaire included items related to frequency of use, issues related to non-compliance and patients' own assessment of the effectiveness of ECS. The second was sent to 69 consultant physicians in geriatric medicine in the Republic of Ireland. This included items relating to prescribing practices, perceived patient compliance and efficacy of ECS in OH.Results: 67 patients responded to the survey (response rate 74%). 64% were female, with a mean age (SD) of 75.1 years (10.5), range 45–91 years. 33% wore ECS daily while 43% never used them. Over half (51%) of the patients reported difficulty in application, 31% reported discomfort and 13% reported ECS were unhelpful for symptoms. More frequent use was associated with improvement in symptoms (p = 0.001). Those aged 75 years or older were more likely to report difficulty in application compared to those under 75 (p = 0.003). 48 physicians responded to the survey (response rate 70%). 89% prescribe ECS for OH, with 67% prescribing them before initiating pharmacological therapy. 53% chose thigh length class 2 compression strength. There were significant differences between the frequency of use reported by patients and predicted by physicians (p < 0.001), with physicians less likely to predict no use or daily use. 89% of physicians predicted that difficulty in application was the main reason for non-compliance.Conclusion: Our findings suggest that although prescribed frequently, the use of ECS in patients with OH is often limited by issues related to practicality. Physicians correctly predicted the main reasons for non-compliance although underestimated the scale of patient compliance with ECS. [ABSTRACT FROM PUBLISHER]