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How do Australian podiatrists manage patients with diabetes? The Australian diabetic foot management survey

Overview of attention for article published in Journal of Foot and Ankle Research, April 2015
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Title
How do Australian podiatrists manage patients with diabetes? The Australian diabetic foot management survey
Published in
Journal of Foot and Ankle Research, April 2015
DOI 10.1186/s13047-015-0072-y
Pubmed ID
Authors

Thomas R Quinton, Peter A Lazzarini, Frances M Boyle, Anthony W Russell, David G Armstrong

Abstract

Diabetic foot complications are the leading cause of lower extremity amputation and diabetes-related hospitalisation in Australia. Studies demonstrate significant reductions in amputations and hospitalisation when health professionals implement best practice management. Whilst other nations have surveyed health professionals on specific diabetic foot management, to the best of the authors' knowledge this appears not to have occurred in Australia. The primary aim of this study was to examine Australian podiatrists' diabetic foot management compared with best practice recommendations by the Australian National Health Medical Research Council. A 36-item Australian Diabetic Foot Management survey, employing seven-point Likert scales (0 = Never; 7 = Always) to measure multiple aspects of best practice diabetic foot management was developed. The survey was briefly tested for face and content validity. The survey was electronically distributed to Australian podiatrists via professional associations. Demographics including sex, years treating patients with diabetes, employment-sector and patient numbers were also collected. Chi-squared and Mann Whitney U tests were used to test differences between sub-groups. Three hundred and eleven podiatrists responded; 222 (71%) were female, 158 (51%) from the public sector and 11-15 years median experience. Participants reported treating a median of 21-30 diabetes patients each week, including 1-5 with foot ulcers. Overall, participants registered median scores of at least "very often" (>6) in their use of most items covering best practice diabetic foot management. Notable exceptions were: "never" (1 (1 - 3)) using total contact casting, "sometimes" (4 (2 - 5)) performing an ankle brachial index, "sometimes" (4 (1 - 6)) using University of Texas Wound Classification System, and "sometimes" (4 (3 - 6) referring to specialist multi-disciplinary foot teams. Public sector podiatrists reported higher use or access on all those items compared to private sector podiatrists (p < 0.01). This study provides the first baseline information on Australian podiatrists' adherence to best practice diabetic foot guidelines. It appears podiatrists manage large caseloads of people with diabetes and are generally implementing best practice guidelines recommendations with some notable exceptions. Further studies are required to identify barriers to implementing these recommendations to ensure all Australians with diabetes have access to best practice care to prevent amputations.

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The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Belgium 1 1%
Unknown 69 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 17 24%
Student > Master 12 17%
Student > Postgraduate 6 9%
Other 5 7%
Student > Ph. D. Student 4 6%
Other 9 13%
Unknown 17 24%
Readers by discipline Count As %
Medicine and Dentistry 24 34%
Nursing and Health Professions 7 10%
Biochemistry, Genetics and Molecular Biology 3 4%
Engineering 3 4%
Psychology 2 3%
Other 10 14%
Unknown 21 30%