Revolutionising lymphoedema treatment - A disruptive technology to improve quality of life

彻底改变淋巴水肿治疗——提高生活质量的颠覆性技术

• 批准号: ES/X006360/1
• 负责人: Katherine Wang
• 金额: $ 6.42万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FX006360%2F1
• 关键词: Revolutionising; lymphoedema; treatment; disruptive; technology

Clinical problem: Cured of a deadly disease (cancer), but left to survive with a lifelong chronic condition (lymphoedema [LE]). LE is a chronic, progressive, and incurable disease. It is caused by the inability of the lymphatic system (the "plumbing" of the body) to remove fluid from the affected area, resulting in excessive swelling (Fig.1A-B). Risks can include increased age, obesity, and commonly, cancer treatments (e.g., surgery, radiotherapy, chemotherapy). It affects up to 70% of breast, prostate, head and neck cancer patients; they face a lifelong risk of developing lymphoedema, which can manifest from weeks to years after cancer treatment; it is a growing aging challenge and an under-met medical problem.Importance: Growing aging problem with negative impact on quality of life (QoL): with an estimated ~120-250 million individuals globally being affected by LE. It continues to increase with the growing aging population (International Lymphoedema Framework-ILF). It is a leading cause of disability worldwide, yet it remains underdiagnosed, undertreated, under-researched, and underfunded in most healthcare systems, mainly due to lack of awareness from both the public and healthcare professionals (HCP). Lymphoedema patients face huge physical, psychological, and socioeconomic consequences which dramatically reduces their QoL, and significantly affect healthy aging. Physical consequences include: disfigurement, disability, fatigue, pain, excessive swelling. Psychological consequences include: anxiety, depression, decreased self-confidence from distorted body image and loss of independence. Socio-economic consequences include: Huge financial burden (£10K increase in annual treatment), due to the high cost of treatment. (e.g., clinic visits, compression therapy, physiotherapy, several times a week). Lack of productivity due to reduced independence from physical consequences. A new approach is needed: Compression strategies to reduce limb volume such as manual lymphatic drainage (MLD - performed by certified massage therapists), and/or the use of an advanced pneumatic compression device (PCD - delivered at specialist clinics) are critical aspects to treatment, which are viewed as barriers to daily life and described as "terrible daily armour". The lack of an effective way of managing the disease and the inaccessibility of treatment means that this has the most significant effect on patients who are lower income. Proposal: In this project, a new wearable sleeve that is fully portable will be designed, developed, manufactured and tested. The aims of this wearable medical device is to 1) Provide a more sustainable, affordable, and accessible alternative treatment for LE patients, using a needs-led approach 2) Increase LE awareness.My objectives is to : 1) Deliver the world's first portable PCD device - "LymphMotion"; allowing the patient to frequently self-manage their condition, empowering them to have a higher sense of self-autonomy and improve their quality of life. 2) Work with LE stakeholders to provide outreach workshops and increase awareness of lymphoedema and effective management strategies.

临床问题：治愈了致命的疾病（癌症），但留下了终身的慢性疾病（淋巴水肿[LE]）。LE是一种慢性、进行性和不可治愈的疾病。它是由淋巴系统（身体的“管道”）不能从受影响的区域移除液体引起的，导致过度肿胀（图1A-B）。风险可能包括年龄增加，肥胖，以及常见的癌症治疗（例如，手术、放疗、化疗）。乳腺癌、前列腺癌、头颈癌患者中有高达70%的人患有淋巴水肿;他们面临着终身淋巴水肿的风险，淋巴水肿可能在癌症治疗后数周至数年内出现;这是一个日益严重的老龄化挑战，也是一个未得到充分解决的医疗问题。重要性：日益严重的老龄化问题对生活质量（QoL）产生负面影响：估计全球约有1.2 - 2.5亿人受LE影响。随着人口老龄化的不断增长，它继续增加（国际脑水肿框架-ILF）。它是全球残疾的主要原因，但在大多数医疗保健系统中，它仍然诊断不足、治疗不足、研究不足和资金不足，这主要是由于公众和医疗保健专业人员（HCP）缺乏认识。脑水肿患者面临巨大的生理、心理和社会经济后果，这大大降低了他们的生活质量，并显著影响健康老龄化。身体后果包括：毁容、残疾、疲劳、疼痛、过度肿胀。心理后果包括：焦虑、抑郁、扭曲的身体形象导致的自信心下降和失去独立性。社会经济后果包括：由于治疗费用高昂，造成巨大的经济负担（每年治疗费用增加1万英镑）。(e.g.,门诊、压迫疗法、物理疗法，每周数次）。由于对身体后果的独立性降低而缺乏生产力。需要采取新的办法：减少肢体体积的压迫策略，如手动淋巴引流（MLD -由认证按摩治疗师执行）和/或使用先进的气动压迫装置（PCD -在专科诊所提供）是治疗的关键方面，被视为日常生活的障碍，并被描述为“可怕的日常盔甲”。缺乏有效的疾病管理方法和无法获得治疗意味着这对低收入患者的影响最大。建议：在该项目中，将设计、开发、制造和测试一种完全便携的新型可穿戴袖子。这个可穿戴医疗设备的目标是1）使用需求导向的方法为LE患者提供更可持续，负担得起和可获得的替代治疗2）提高LE意识。我的目标是：1）提供世界上第一个便携式PCD设备-“LymphMotion”;允许患者经常自我管理他们的病情，使他们能够有更高的自我自主意识，提高他们的生活质量。2)与LE利益相关者合作，提供外展研讨会，提高对淋巴水肿和有效管理策略的认识。