Nottingham research having global impact for thousands living with chronic condition
Two research clinicians at Nottingham University Hospitals (NUH) NHS Trust are leading an international study that is transforming the lives of thousands of people living with a long-term chronic condition.
Dr Eleanore Dring and Professor Christine Moffatt CBE are leading LIMPRINT, a global epidemiology study into chronic oedema that started in Nottingham and involves multiple countries.
The aim is to identify the number of patients within health services affected by the condition - often described as lymphoedema - and the impact that it has, leading to the creation of an international dataset of more than 15,000 patients.
Lymphoedema is a complex array of conditions that usually present with enlargement of limbs and is anecdotally referred to as Elephantiasis, due to the huge size the limbs may reach. These changes frequently result in complications such as cellulitis (a bacterial skin condition) that may cause hospitalisation and death. In complex cases lymphoedema may also affect internal organs. Evidence strongly indicates the impact this condition has on all aspects of quality of life and well-being.
LIMPRINT started in Nottingham University Hospitals (NUH) NHS Trust in partnership with the University of Nottingham. The aim was to identify the number of patients within health services affected by the condition and the impact that it has, leading to the creation of an international dataset of more than 14,000 patients.
The initial cohort of nine countries included Australia, Canada, Denmark, France, Southern Ireland, Italy, Japan, Turkey and the UK.
LIMPRINT is now launching in Saudi Arabia and Bulgaria and will form a central part of a Melinda Gates Foundation Grant in eight sites in India.
And a partnership with Professor Linda Gibson at Nottingham Trent University is supporting the development of a LIMPRINT study in Uganda.
Christine Moffatt CBE is Professor of Skin Integrity at NUH and Emeritus Professor at the University of Nottingham. She has worked in this role with the Institute of Care Excellence since 2020; before this she worked with the University of Nottingham and Nottingham Trent University for over a decade.
Professor Moffatt has been involved in wound-healing research and practice for 35 years and lymphoedema research since 1999 and has always maintained a clinical academic role.
She heads the International Lymphoedema Framework (ILF), a charity whose mission is to develop effective care throughout the world and who were instrumental in supporting the design and roll-out of LIMPRINT through its partner countries. LIMPRINT (Lymphoedema IMpact and PRevalence INTernational) also aims to define the impact of chronic oedema in specific patient groups, such as those with multiple sclerosis and spina bifida; those undergoing bariatric surgery; prisoners and people in community nursing homes; and long-term users of mental health services.
The work of LIMPRINT and related work is already driving change in policy and reimbursement across the world, including:
- Partnership research to develop new compression materials using sensor technology with Dr Yang Wei at Nottingham Trent University (British Physical Science Research Council)
- Contribution to the passing of the Lymphoedema Treatment Act in the USA, which means treatment for thousands of patients will be covered by the Medicare reimbursement system from 2024 for the first time.
- Reimbursement in Japan for treatment of cancer-related lymphoedema.
- Changes in reimbursement of lymphoedema care in Italy
- Development of a nationally funded integrated-care pathway in France
- Development of Lymphoedema Wales, a Welsh government initiative that has received multiple awards for excellence.
- Funding of a multi-million Gates Foundation grant in India with the ILF to develop centres of excellence
- Adoption by the WHO of a model of care that integrates allopathic and Ayurveda approaches to management of lymphoedema.
- Acknowledgment by WHO and Gates Foundation of the potential to improve care throughout the world though a programme of development.
NUH will co-host the next International Lymphoedema Framework Conference at the East Midlands Conference Centre in June in partnership Lymphoedema Wales and the International Lipoedema Association. The conference is expected to draw more than 600 delegates from all over the world, and will include skills zones where clinicians can learn about new management approaches; some sessions will be recorded to allow NUH staff access to the learning after the event.
A dedicated patient conference will run alongside the professional programme, where patients with lymphoedema can learn more about self-management.
Dr Dring said: “Leading the implementation of the LIMPRINT study was a defining moment in my career; realisation of the importance and impact of nurse-led research, which is undertaken at the bedside.
“It is so inspiring to be involved in a study which has had such a global impact, and is aimed at improving the lives of individuals living with lymphoedema.”
Her involvement led to her successful application to the NIHR 70@70 The Senior Nurse and Midwife Research Leader Programme, which aims to “strengthen the research voice and influence of nurses and midwives in health and social care settings. It will also enhance the connection between the research voice and perspectives of NHS nurses and midwives with the NIHR research agendas”.
Professor Moffatt said: “When I’m asked about nurses’ role in research I hope this is an example of what can be achieved through nurse-led projects: there is no limit only the size of the vision you believe in and the belief in the power of partnership and belonging together.
“I am proud and happy to do all I can with a great team at NUH and hope at the conference in June you will be able to see some of this wider work.”
To read more, visit: LIMPRINT - International Lymphoedema Framework
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