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Prioritisation of diabetes-related footcare amongst primary care healthcare professionals

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Mullan, Leanne ; Wynter, Karen ; Driscoll, Andrea ; Rasmussen, Bodil. / Prioritisation of diabetes-related footcare amongst primary care healthcare professionals. In: Journal of Clinical Nursing. 2020 ; Vol. 29, No. 23-24. pp. 4653-4673.

Bibtex

@article{a21e2a7de4734624a33670a0d019f89e,
title = "Prioritisation of diabetes-related footcare amongst primary care healthcare professionals",
abstract = "AIMS AND OBJECTIVES: To assess primary healthcare professionals' priority for managing diabetic foot disease (DFD) over the progressive course of the condition compared to other aspects of diabetes care.BACKGROUND: DFD affects up to 60 million people globally. Evidence suggests that comprehensive preventative footcare may reduce serious complications of DFD, such as amputation.DESIGN: A cross-sectional quantitative study reported according to STROBE statement.METHODS: General Practitioners (GPs) and Credentialled Diabetes Educators (CDEs) working within Australian primary care were invited to complete an online survey, to obtain information about preventative and early intervention footcare priorities and practices. Ten GPs and 84 CDEs completed the survey.RESULTS: On diagnosis of type 2 diabetes, haemoglobin A1c (HbA1c) review was identified to be one of the top three priorities of care by 57 (61%) of participants whilst at 20-year history of diabetes 73 (78%) participants indicated its priority. Foot assessments became a priority for 78% (n = 73) of participants and podiatry referrals a priority for 53% (n = 50) of participants only when a {"}foot concern{"} was raised. Referrals to specialist high-risk foot podiatrists or services were a first priority for 56% (n = 53), when the person had significant amputation risk factors.CONCLUSION: Diabetes-related preventative footcare assessments and management remain a low priority amongst primary healthcare professionals. Preventative care for asymptomatic complications, such as DFD, may be overlooked in favour of monitoring HbA1c or medication management. Limited prioritisation of footcare in primary care is concerning given the risks for amputation associated with DFD.RELEVANCE TO CLINICAL PRACTICE: This study reveals the need for primary healthcare decision makers and clinicians to ensure preventative footcare is a focused priority earlier in the diabetes care continuum. Collaborative and widespread promotion of the importance of proactive rather than reactive footcare practices is required to support prevention of foot ulcers and amputation.",
keywords = "Australia, diabetes, diabetic foot disease, foot, footcare, prevention, priority, ulcer",
author = "Leanne Mullan and Karen Wynter and Andrea Driscoll and Bodil Rasmussen",
note = "{\textcopyright} 2020 John Wiley & Sons Ltd.",
year = "2020",
month = dec,
doi = "10.1111/jocn.15506",
language = "English",
volume = "29",
pages = "4653--4673",
journal = "Journal of Clinical Nursing",
issn = "0962-1067",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "23-24",

}

RIS

TY - JOUR

T1 - Prioritisation of diabetes-related footcare amongst primary care healthcare professionals

AU - Mullan, Leanne

AU - Wynter, Karen

AU - Driscoll, Andrea

AU - Rasmussen, Bodil

N1 - © 2020 John Wiley & Sons Ltd.

PY - 2020/12

Y1 - 2020/12

N2 - AIMS AND OBJECTIVES: To assess primary healthcare professionals' priority for managing diabetic foot disease (DFD) over the progressive course of the condition compared to other aspects of diabetes care.BACKGROUND: DFD affects up to 60 million people globally. Evidence suggests that comprehensive preventative footcare may reduce serious complications of DFD, such as amputation.DESIGN: A cross-sectional quantitative study reported according to STROBE statement.METHODS: General Practitioners (GPs) and Credentialled Diabetes Educators (CDEs) working within Australian primary care were invited to complete an online survey, to obtain information about preventative and early intervention footcare priorities and practices. Ten GPs and 84 CDEs completed the survey.RESULTS: On diagnosis of type 2 diabetes, haemoglobin A1c (HbA1c) review was identified to be one of the top three priorities of care by 57 (61%) of participants whilst at 20-year history of diabetes 73 (78%) participants indicated its priority. Foot assessments became a priority for 78% (n = 73) of participants and podiatry referrals a priority for 53% (n = 50) of participants only when a "foot concern" was raised. Referrals to specialist high-risk foot podiatrists or services were a first priority for 56% (n = 53), when the person had significant amputation risk factors.CONCLUSION: Diabetes-related preventative footcare assessments and management remain a low priority amongst primary healthcare professionals. Preventative care for asymptomatic complications, such as DFD, may be overlooked in favour of monitoring HbA1c or medication management. Limited prioritisation of footcare in primary care is concerning given the risks for amputation associated with DFD.RELEVANCE TO CLINICAL PRACTICE: This study reveals the need for primary healthcare decision makers and clinicians to ensure preventative footcare is a focused priority earlier in the diabetes care continuum. Collaborative and widespread promotion of the importance of proactive rather than reactive footcare practices is required to support prevention of foot ulcers and amputation.

AB - AIMS AND OBJECTIVES: To assess primary healthcare professionals' priority for managing diabetic foot disease (DFD) over the progressive course of the condition compared to other aspects of diabetes care.BACKGROUND: DFD affects up to 60 million people globally. Evidence suggests that comprehensive preventative footcare may reduce serious complications of DFD, such as amputation.DESIGN: A cross-sectional quantitative study reported according to STROBE statement.METHODS: General Practitioners (GPs) and Credentialled Diabetes Educators (CDEs) working within Australian primary care were invited to complete an online survey, to obtain information about preventative and early intervention footcare priorities and practices. Ten GPs and 84 CDEs completed the survey.RESULTS: On diagnosis of type 2 diabetes, haemoglobin A1c (HbA1c) review was identified to be one of the top three priorities of care by 57 (61%) of participants whilst at 20-year history of diabetes 73 (78%) participants indicated its priority. Foot assessments became a priority for 78% (n = 73) of participants and podiatry referrals a priority for 53% (n = 50) of participants only when a "foot concern" was raised. Referrals to specialist high-risk foot podiatrists or services were a first priority for 56% (n = 53), when the person had significant amputation risk factors.CONCLUSION: Diabetes-related preventative footcare assessments and management remain a low priority amongst primary healthcare professionals. Preventative care for asymptomatic complications, such as DFD, may be overlooked in favour of monitoring HbA1c or medication management. Limited prioritisation of footcare in primary care is concerning given the risks for amputation associated with DFD.RELEVANCE TO CLINICAL PRACTICE: This study reveals the need for primary healthcare decision makers and clinicians to ensure preventative footcare is a focused priority earlier in the diabetes care continuum. Collaborative and widespread promotion of the importance of proactive rather than reactive footcare practices is required to support prevention of foot ulcers and amputation.

KW - Australia

KW - diabetes

KW - diabetic foot disease

KW - foot

KW - footcare

KW - prevention

KW - priority

KW - ulcer

UR - http://www.scopus.com/inward/record.url?scp=85092040694&partnerID=8YFLogxK

U2 - 10.1111/jocn.15506

DO - 10.1111/jocn.15506

M3 - Journal article

C2 - 32956503

VL - 29

SP - 4653

EP - 4673

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 23-24

ER -

ID: 61375331