Evaluation of a diabetic foot screening and protection programme

McCabe, C; Stevenson, Richard; Dolan, Anthony

doi:10.1002/(sici)1096-9136(199801)15:1<80::aid-dia517>3.0.co;2-k

Cited by 180 publications

(110 citation statements)

References 3 publications

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“…It is relevant that our failure to observe a fall in ulcer incidence echoes the observations of McCabe and colleagues in a similar, but only partly randomised study of a population at high risk in UK [14]. This group, however, did observe that the incidence of amputation was lower in their intervention group and one interpretation of this finding is that the education programme may encourage a patient with a new ulcer to seek expert help earlier and that this may lead to an improved outcome.…”

Section: Discussionsupporting

confidence: 78%

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Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

et al. 2008

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Aims/hypothesis This observer-blind, randomised controlled trial was designed to determine the effect of a foot care education programme in the secondary prevention of foot ulcers. Methods People with newly healed foot ulcers attending one of three specialist clinics were allocated to receive either targeted, one-to-one education or usual care, using a computer-generated random allocation sequence that had been prepared in advance but which was concealed from the clinical researcher. The primary outcome was ulcer incidence at 12 months. Secondary outcomes were ulcer incidence at 6 months and incidence of amputation, mood (Hospital Anxiety and Depression Scale) and quality of life (Diabetic Foot Ulcer Scale) at 6 and 12 months. Protective foot care behaviours (Nottingham Assessment of Functional Footcare) were assessed at 12 months. Results There were 87 (mean [SD] age 63.5 [12.1] years) patients in the intervention group and 85 control patients (mean [SD] age 64.9 [10.9] years). The groups were comparable at baseline. No significant differences (p> 0.05) were observed between groups in ulcer incidence at either 6 months (intervention 30%, control 21%) or 12 months (intervention 41%, control 41%). Recommended foot care behaviours at 12 months were better in the intervention than in the control group (p=0.03), but education had no significant (p>0.05) effect on mood, quality of life or amputations. Conclusions/interpretation Even though the intervention was associated with improved foot care behaviour, there was no evidence that this programme of targeted education was associated with clinical benefit in this population when compared with usual care. The usefulness and optimal delivery of education to such a high-risk group requires further evaluation.

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Section: Discussionsupporting

confidence: 78%

“…A reduced incidence of new foot ulcers has been shown when foot care education was included as part of an integrated package of diabetes care delivered to selected and relatively disadvantaged groups in the USA [12,13], but has not been confirmed in other studies [14][15][16][17][18][19].…”

mentioning

confidence: 99%

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

et al. 2008

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“…Unfortunately, a systematic review of studies of preventative foot care education was unable to confirm the usefulness of education [47]. There is, however, a suggestion that education and regular podiatric care may result in earlier presentation when ulcers develop [48].…”

Section: Causal Pathways To Foot Ulcerationmentioning

confidence: 99%

The diabetic foot: from art to science. The 18th Camillo Golgi lecture

2004

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Diabetic foot ulceration represents a major medical, social and economic problem all over the world. While more than 5% of diabetic patients have a history of foot ulceration, the cumulative lifetime incidence may be as high as 15%. Ethnic differences exist in both ulcer and amputation incidences, with both being less common in patients of Indian subcontinent origin living in the UK. Foot ulceration results from the interaction of several contributory factors, the most important of which is neuropathy. With respect to the management of acute Charcot neuroarthropathy in diabetes, recent studies suggest that bisphosphonates reduce disease activity as judged not only by differences in skin temperature, but also by assessing markers of bone turnover. The use of the total-contact cast is demonstrated in the treatment of acute Charcot feet and of plantar neuropathic ulcers. Histological evidence suggests that pressure relief results in chronic foot ulcers changing their morphological appearance by displaying some features of an acute wound. Thus, repetitive stresses on the insensate foot appear to play a major role in maintaining ulcer chronicity. It is hoped that increasing research activity in foot disease will ultimately result in fewer ulcers and less amputation in diabetes.

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“…Recommended self-care practices include regular inspection of feet, selection of appropriate footwear, and avoidance of risks such as sharp instruments and abrasives [11][12]. Well-coordinated preventive foot care can reduce diabetes-related lower-limb complications [13][14][15]. Consensus on methods of care for the diabetic foot is emerging internationally, and cost-effectiveness projections indicate that guideline-based treatment for diabetic foot problems may improve clinical outcomes and decrease total costs [16].…”

Section: Introductionmentioning

confidence: 99%

Personal and treatment factors associated with foot self-care among veterans with diabetes

Johnston¹,

Pogach²,

Rajan³

et al. 2006

JRRD

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Abstract-We developed and validated a survey of foot selfcare education and behaviors in 772 diabetic patients with high-risk feet at eight Department of Veterans Affairs medical centers. Principal components analysis identified six subscales with satisfactory internal consistency: basic foot-care education, extended foot-care education, basic professional foot care, extended professional foot care, basic foot self-care, and extended foot self-care (alpha = 0.77-0.91). Despite high illness burden, adherence to foot self-care recommendations was less than optimal; only 32.2% of participants reported looking at the bottom of their feet daily. Independent predictors of greater adherence to basic foot self-care practices included African-American or Hispanic background, perceived neuropathy, foot ulcers in the last year, prior amputation (beta = 0.08-0.12, p < 0.04-0.001), and provision of greater basic and extended education (beta = 0.16, p < 0.004, and beta = 0.15, p < 0.007). The survey subscales can now be used for evaluating foot care and education needs for persons with high-risk feet.

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Evaluation of a diabetic foot screening and protection programme

Cited by 180 publications

References 3 publications

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

The diabetic foot: from art to science. The 18th Camillo Golgi lecture

Personal and treatment factors associated with foot self-care among veterans with diabetes

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