Chris Manu1, Elisabetta Lacopi2, Benjamin Bouillet3, Julien Vouillarmet4, Raju Ahluwalia1, Claas Lüdemann5, José Luis Garcia-Klepzig6, Marco Meloni7, Víctor Rodriguez-Saenz De Buruaga8, Juan Pedro Sánchez-Ríos9, Mike Edmonds1, Jan Apelqvist10, José Luis Lázaro-Martínez11, Kristien Van Acker12. 1. King's College Hospital, Denmark Hill, SE5 9RS London. 2. University of Pisa, Ospedale di Cisanello, via Paradisa 2, 56126 Pisa. 3. CHU de Dijon, 2 boulevard Maréchal de Lattre de Tassigny, 21000 DIJON. 4. JCHU Lyon Sud, Pavillon Médical, 165 chemin du Grand Revoyet 69495 Pierre Bénite. 5. Franziskus Krankenhaus Berlin, Budapester Strasse, 15-19, 10787 BERLIN. 6. Hospital Clinico San Carlos De Madrid, Calle Profesor Martin Lagos, 28040 Madrid. 7. University of Roma Tor Vergata, Viale Oxford 81, 00133 Roma. 8. Donostia Hospital Universitario San Sebastian, Calle Prim N° 14 - 20006 San Sebastian. 9. Hospital Universitario Fundacion Alcorcon, Calle Budapest, 1, 28922 Alcorcón, Madrid. 10. Department of Endocrinology, University Hospital of Malmö, S-205 02 Malmö, Sweden. 11. Universidad Complutense de Madrid. 12. Familie Ziekenhuis. Department of Endocrinology. Chimay. Belgium.
Abstract
OBJECTIVE: Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. METHOD: A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU. The second part of the questionnaire collected data on recently managed DFU cases. RESULTS: There were 600 questionnaires collected in the first part of the study (150 per country), and 1188 patient cases of DFU management were included in the second part. Up to 95% of patients had type 2 diabetes. Patients' complaints led to diagnosis, on average, 60% of the time, and the diagnosis was an incidental finding during a consultation 13-28% of the time. On average, only 40% of GPs completely agreed that they have clearly identified DFU clinical practitioners working in a hospital facility. In 55-66% of cases, the duration of DFU was unknown or DFU diagnosis was delayed more than three weeks from the onset of the wound. On average, 48% of patients were referred after an unknown duration or more than one month from the onset of DFU. CONCLUSION: Despite differences in health-care structures across Europe, delays in referral to specialist foot care teams seems to be a common theme. There is an ongoing need to educate GPs, nurses and patients to be more aware of the risk of DFU, and the need for prompt referral to specialist diabetic foot teams.
OBJECTIVE:Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. METHOD: A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU. The second part of the questionnaire collected data on recently managed DFU cases. RESULTS: There were 600 questionnaires collected in the first part of the study (150 per country), and 1188 patient cases of DFU management were included in the second part. Up to 95% of patients had type 2 diabetes. Patients' complaints led to diagnosis, on average, 60% of the time, and the diagnosis was an incidental finding during a consultation 13-28% of the time. On average, only 40% of GPs completely agreed that they have clearly identified DFU clinical practitioners working in a hospital facility. In 55-66% of cases, the duration of DFU was unknown or DFU diagnosis was delayed more than three weeks from the onset of the wound. On average, 48% of patients were referred after an unknown duration or more than one month from the onset of DFU. CONCLUSION: Despite differences in health-care structures across Europe, delays in referral to specialist foot care teams seems to be a common theme. There is an ongoing need to educate GPs, nurses and patients to be more aware of the risk of DFU, and the need for prompt referral to specialist diabetic foot teams.
Authors: Marco Meloni; Jose Luis Lazaro-Martínez; Raju Ahluwalia; Benjamin Bouillet; Valentina Izzo; Michela Di Venanzio; Elisabetta Iacopi; Chris Manu; José Luis Garcia-Klepzig; Juan Pedro Sánchez-Ríos; Claas Lüedemann; Víctor Rodriguez-Saenz De Buruaga; Julien Vouillarmet; Jérôme Guillaumat; Anna Rita Aleandri; Laura Giurato; Micheal Edmonds; Alberto Piaggesi; Kristien Van Acker; Luigi Uccioli Journal: Acta Diabetol Date: 2021-05-03 Impact factor: 4.280
Authors: Marco Meloni; Benjamin Bouillet; Raju Ahluwalia; Claas Lüdemann; Juan Pedro Sánchez-Ríos; Elisabetta Iacopi; José Luis Lazaro-Martinez Journal: Diabetes Metab Res Rev Date: 2020-08-25 Impact factor: 8.128