Post the Pandemic: How will COVID-19 Transform Diabetic Foot Disease Management?

Najafi, Bijan

doi:10.1177/1932296820930290

Cited by 17 publications

(19 citation statements)

References 17 publications

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“…Because people with diabetic feet represent a fragile population, they have been urged to avoid unnecessary hospital admissions and outpatient visits to reduce their exposure risk to COVID-19. This has disrupted best practices for preventing disease-related complications [ 52 ]. In response, many healthcare providers are re-engineering their pathways to promote “care in place”.…”

Section: Care In Placementioning

confidence: 99%

“…Although there is no evidence-based study assessing HaH care’s benefit over usual care in the context of diabetes, there is a rapid growth in professional home care services. For instance, BestBuy Health, a leading provider of technology products, is expanding its healthcare digital wellness efforts and moving from selling wearables and devices to adding services needed to help patients with chronic illness [ 52 ]. Similarly, Medically Home, a Boston-based company, offers an integrated technology platform and network of in-home services under Mayo Clinic physicians and providers’ guidance.…”

Section: Care In Placementioning

confidence: 99%

“…We anticipate pandemic will accelerate the adoption of the HaH care delivery model. Moreover, home-based medical care will be mainstreamed into the US healthcare delivery system for wide ranges of acute and subacute conditions, including managing severe cases of DFU [ 52 ].…”

Section: Care In Placementioning

confidence: 99%

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Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review

Najafi

Mishra

2021

Medicina

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About 422 million people worldwide have diabetes and approximately one-third of them have a major risk factor for diabetic foot ulcers, including poor sensation in their feet from peripheral neuropathy and/or poor perfusion to their feet from peripheral artery disease. The current healthcare ecosystem, which is centered on the treatment of established foot disease, often fails to adequately control key reversible risk factors to prevent diabetic foot ulcers leading to unacceptable high foot disease amputation rate, 40% recurrence of ulcers rate in the first year, and high hospital admissions. Thus, the latest diabetic foot ulcer guidelines emphasize that a paradigm shift in research priority from siloed hospital treatments to innovative integrated community prevention is now critical to address the high diabetic foot ulcer burden. The widespread uptake and acceptance of wearable and digital health technologies provide a means to timely monitor major risk factors associated with diabetic foot ulcer, empower patients in self-care, and effectively deliver the remote monitoring and multi-disciplinary prevention needed for those at-risk people and address the health care access disadvantage that people living in remote areas. This narrative review paper summarizes some of the latest innovations in three specific areas, including technologies supporting triaging high-risk patients, technologies supporting care in place, and technologies empowering self-care. While many of these technologies are still in infancy, we anticipate that in response to the Coronavirus Disease 2019 pandemic and current unmet needs to decentralize care for people with foot disease, we will see a new wave of innovations in the area of digital health, smart wearables, telehealth technologies, and “hospital-at-home” care delivery model. These technologies will be quickly adopted at scale to improve remote management of diabetic foot ulcers, smartly triaging those who need to be seen in outpatient or inpatient clinics, and supporting acute or subacute care at home.

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Section: Care In Placementioning

confidence: 99%

Section: Care In Placementioning

confidence: 99%

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Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review

Najafi

Mishra

2021

Medicina

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“…As the famous Irish physician, Dominic Corrigan, whose observations of aortic incompetence are now known as “Corrigan’s sign” wrote, “the trouble with most doctors is not that they do not know enough but they do not see enough.” A careful examination of the feet in people with diabetes is absolutely essential, and it always has been and always will be. However, as speculated by Najafi [ 24 ], the COVID-19 experience will likely transform our approach to the management of diabetic foot disease. There will undoubtedly be a new wave of innovations in the areas of digital health, smart technology including pressure or temperature sensing insoles, telehealth technologies, and more.…”

Section: Conclusion and The Futurementioning

confidence: 99%

Diabetic Foot Disease during the COVID-19 Pandemic

Boulton

2021

Medicina

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Throughout 2020, the COVID-19 pandemic has had a major impact on the care of non-communicable diseases across the world and diabetes is no exception. Whereas many branches of medicine have adapted to telemedicine, this is difficult and challenging for the diabetic foot which often requires “hands on” treatment. This review covers the challenges that have faced clinicians across the world in the management of complex diabetic foot problems and also includes some illustrative case vignettes which show how it is possible to manage foot ulcers without the usual access to laboratory and radiological testing. There is no doubt that the COVID-19 experience when handling diabetic foot problems will likely transform our approach to the management of diabetic foot disease especially in the areas of digital health and smart technology.

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“…In such a context, Tuscany Health Authorities gave to Diabetologist and Diabetic foot care specialist the possibility to manage chronic patients through a dedicated system of telemedicine, supplying both software and hardware for a program of telemedicine, that we used to maintain a contact with our patients in need of close monitoring [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

I fear COVID but diabetic foot (DF) is worse: a survey on patients’ perception of a telemedicine service for DF during lockdown

et al. 2021

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Aims To evaluate the patients' perceptions of telemedicine visits during COVID-19 lockdown and their level of anxiety about COVID and diabetic foot (DF). Methods In May 2020, we contacted by phone all the patients who underwent in March and April to remote monitoring visits for DF during the lockdown for COVID-19, with a structured interview, focusing on their perceptions about telemedicine service for DF and on the anxiety toward COVID and DF. Results We analyzed 257 remote monitoring visits in 211 patients. Two hundred and six patients answered the follow-up interview; 177 patients (85.9%) remembered the monitoring visit, 140 (67.9%) the health care professional and 181 patients (87.9%) the reason of contact; 169 patients were alone during the visit, 37 with a relative. Patients judged useful both the monitoring during pandemic (4.35 ± 0.28 on a maximum of five) and the possibility to continue after the lockdown (4.34 ± 0.23 on a maximum of five). Eventually, we observed that DF patients were more worried by DF than by COVID on a scale from 0 (not fear at all) to 5 (terrified) (4.79 ± 0.05 vs. 3.27 ± 1.03, p < 0.05). This difference was higher in previously ulcerated patients (4.84 ± 0.03 vs. 3.03 ± 1.13, p < 0.05) and even more in amputees (4.93 ± 0.03 vs. 2.73 ± 1.21, p < 0.05). Conclusions DF patients appreciated televisits during lockdown and the continuation of this service after its end. In this context DF prevails on COVID in the worries of patients, especially if they are recurrent ones. Keywords Diabetic foot • COVID • Follow-up • PandemicThis article belongs to the topical collection Health Education and Psycho-Social Aspects, managed by Massimo Porta and Marina Trento.

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Post the Pandemic: How will COVID-19 Transform Diabetic Foot Disease Management?

Cited by 17 publications

References 17 publications

Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review

Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review

Diabetic Foot Disease during the COVID-19 Pandemic

I fear COVID but diabetic foot (DF) is worse: a survey on patients’ perception of a telemedicine service for DF during lockdown

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