A comparison of programmable and nonprogrammable compression devices for treatment of lymphoedema using an administrative health outcomes dataset

Pinar Karaca Mandic, A. T. Hirsch, S. G. Rockson, S. H. Ridner

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Patients with lymphoedema experience lifelong swelling and recurrent cellulitis despite use of complete decongestive therapy. Pneumatic compression devices (PCDs), including nonprogrammable and programmable devices that meet individual patient needs, support long-term self-care in the home. Objectives: Patients with either a nonprogrammable device (NP-PCD) or a dynamic pressure programmable device [P-PCD; Flexitouch ® (Tactile Medical, Minneapolis, MN, U.S.A.)] were evaluated to compare associated clinical and health utilization outcomes pre-/postdevice acquisition. Methods: Retrospective analysis of deidentified administrative claims from 2007 through 2013 of a large U.S. insurer. Outcome variables included rates of lymphoedema-related cellulitis, manual therapy use, outpatient services and inpatient hospitalizations. Multivariate regression analysis was performed to (i) compare outcomes for the 12 months pre- and postdevice acquisition and (ii) compare these two device types for their treatment-associated benefits. Results: The sample consisted of 1013 NP-PCD and 718 P-PCD recipients. Compared with the NP-PCD group, P-PCD patients’ baseline cellulitis rate was higher, whereas their postdevice cellulitis rate was lower. In the cancer cohort, the NP-PCD group had a 53% reduction in episodes of cellulitis (from 17·9% to 8·5%), compared with a greater 79% reduction in the P-PCD group (from 23·7% to 5·0%) (P < 0·001). In the noncancer cohort, the P-PCD group also experienced a larger 76% decline (from 31·0% to 7·4%) vs. 54% decline (from 22·9% to 10·6%) in cellulitis rates (P = 0·003). Outpatient service use reduced in both device groups, with greater reductions observed in the P-PCD group. Both device groups experienced reductions in manual therapy use. Inpatient hospitalizations were largely stable with reductions observed only in the noncancer cohort of the P-PCD group. Conclusions: P-PCD receipt was associated with superior lymphoedema-related health outcomes and reductions in cellulitis.

Original languageEnglish (US)
Pages (from-to)1699-1707
Number of pages9
JournalBritish Journal of Dermatology
Issue number6
StatePublished - 2017

Bibliographical note

Funding Information:
This study was supported in part by Tactile Medical (Minneapolis, MN, U.S.A.) to defray access costs for use of the Optum Health database and defray health economic analytic costs. Tactile Medical did not perform any study-related analyses. The investigators had independent control of the study design, full access to all data and performed the analyses independently. The manuscript was drafted and all versions were edited by the first author.

Publisher Copyright:
© 2017 British Association of Dermatologists


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