José Luis Garcia-Klepzig1, Juan Pedro Sánchez-Ríos2, Chris Manu3, Raju Ahluwalia4, Claas Lüdemann5, Marco Meloni6, Elisabetta Lacopi7, Víctor Rodriguez-Saenz De Buruaga8, Benjamin Bouillet9, Julien Vouillarmet10, José Luis Lázaro-Martínez11, Kristien Van Acker12. 1. Internal Medicine Department, Hospital Clinico San Carlos De Madrid, Calle Profesor Martin Lagos, 28040 Madrid. 2. Diabetic Foot Unit, Vascular Surgery Department, Hospital Fundación Alcorcón, Madrid, Spain. 3. Diabetes Research Fellow; King's College Hospital, Denmark Hill, London. 4. Trauma and Ortophaedic Department, King´s College Hospital, London, UK. 5. Franziskus Krankenhaus Berlin, Budapester Strasse, Berlin. 6. Diabetic Foot Center, University of Roma Tor Vergata, Viale Oxford 81, Roma. 7. Diabetic Foot Section, University of Pisa, Ospedale di Cisanello, via Paradisa 2, Pisa. 8. Vascular Surgery Department, Donostia Hospital Universitario San Sebastian, Calle Prim N° 14 - 20006 San Sebastian. 9. Endocrinology Department, University Hospital Center, Dijon, France. 10. Endocrinology Department, University Hospital Center, Lyon, France. 11. Diabetic foot Unit, Universidad Complutense de Madrid, Spain. 12. Familie Ziekenhuis, Department of Endocrinology, Chimay, Belgium.
Abstract
OBJECTIVE: Diabetic foot ulcers (DFU) have the potential to deteriorate rapidly, in the absence of prompt assessment and treatment. The aim of this study was to analyse the awareness and perception of DFU among general practitioners (GPs) from four European countries, and to find possible differences between these countries in terms of management. METHOD: A two-part, quantitative, online questionnaire was distributed to GPs across four countries in Europe-the UK, France, Germany and Spain. The first part entailed a survey on the perception and knowledge of the pathogenesis and management of DFU, among GPs. The second part of the questionnaire was used for the collection of data on recently-managed DFU cases. RESULTS: For the first part of the study, 600 questionnaires were collected (150 per country) and 1188 patient cases of DFU management were included in the second part. In France, only 49% of GPs mentioned neuropathy as the main causative process in DFU development. However, in Germany and the UK, 82% and 83% of GPs, respectively, considered neuropathy as an important causative factor. DFU care in Spain and the UK is thought to be organised by multidisciplinary teams (MDT) (83% and 84% of GPs, respectively, completely agreed with this statement). In France and Germany, GPs are responsible for follow-up and management. Only UK physicians have clearly identified specialised podiatrists to refer patients to, if needed. Approximately 29-40% of GPs in all countries did not feel they were sufficiently trained in the DFU treatment protocol. Almost 30% of GPs in France and Germany thought that DFU treatment was not well-established due to the absence of clinical guidelines and protocols. CONCLUSION: The intra-country and inter-country management of the complex aspects of DFU is quite heterogeneous. The cause of this finding is multifactorial. Although there are international guidelines, it would be beneficial to establish clear and specific competencies for the different health professionals involved in DFU management. As a minimum, intra-country heterogeneity should improve with their development.
OBJECTIVE:Diabetic foot ulcers (DFU) have the potential to deteriorate rapidly, in the absence of prompt assessment and treatment. The aim of this study was to analyse the awareness and perception of DFU among general practitioners (GPs) from four European countries, and to find possible differences between these countries in terms of management. METHOD: A two-part, quantitative, online questionnaire was distributed to GPs across four countries in Europe-the UK, France, Germany and Spain. The first part entailed a survey on the perception and knowledge of the pathogenesis and management of DFU, among GPs. The second part of the questionnaire was used for the collection of data on recently-managed DFU cases. RESULTS: For the first part of the study, 600 questionnaires were collected (150 per country) and 1188 patient cases of DFU management were included in the second part. In France, only 49% of GPs mentioned neuropathy as the main causative process in DFU development. However, in Germany and the UK, 82% and 83% of GPs, respectively, considered neuropathy as an important causative factor. DFU care in Spain and the UK is thought to be organised by multidisciplinary teams (MDT) (83% and 84% of GPs, respectively, completely agreed with this statement). In France and Germany, GPs are responsible for follow-up and management. Only UK physicians have clearly identified specialised podiatrists to refer patients to, if needed. Approximately 29-40% of GPs in all countries did not feel they were sufficiently trained in the DFU treatment protocol. Almost 30% of GPs in France and Germany thought that DFU treatment was not well-established due to the absence of clinical guidelines and protocols. CONCLUSION: The intra-country and inter-country management of the complex aspects of DFU is quite heterogeneous. The cause of this finding is multifactorial. Although there are international guidelines, it would be beneficial to establish clear and specific competencies for the different health professionals involved in DFU management. As a minimum, intra-country heterogeneity should improve with their development.
Entities:
Keywords:
diabetes mellitus; diabetic foot ulcers; general practitioners
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