Advanced

Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study

Prompers, L; Huijberts, M; Apelqvist, Jan LU ; Jude, E; Piaggesi, A; Bakker, K; Edmonds, M; Holstein, P; Jirkovska, A and Mauricio, D, et al. (2008) In Diabetic Medicine 25(6). p.700-707
Abstract
Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study entry, 77% of the patients had no or inadequate offloading. During follow-up, casting was used in 35% (0-68%) of the plantar fore- or midfoot... (More)
Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study entry, 77% of the patients had no or inadequate offloading. During follow-up, casting was used in 35% (0-68%) of the plantar fore- or midfoot ulcers. Predictors of use of casting were male gender, large ulcer size and being employed. Vascular imaging was performed in 56% (14-86%) of patients with severe limb ischaemia; revascularization was performed in 43%. Predictors of use of vascular imaging were the presence of infection and ischaemic rest pain. Conclusion Treatment of many patients is not in line with current guidelines and there are large differences between countries and centres. Our data suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot disease. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
infection, diabetic foot, PAD, deliver of care
in
Diabetic Medicine
volume
25
issue
6
pages
700 - 707
publisher
Wiley-Blackwell
external identifiers
  • wos:000256376400010
  • scopus:44649084923
ISSN
1464-5491
DOI
10.1111/j.1464-5491.2008.02445.x
language
English
LU publication?
yes
id
5248f307-c007-4e7b-8482-37ef4c506ac0 (old id 1201335)
date added to LUP
2008-09-15 09:54:43
date last changed
2017-07-02 03:48:39
@article{5248f307-c007-4e7b-8482-37ef4c506ac0,
  abstract     = {Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study entry, 77% of the patients had no or inadequate offloading. During follow-up, casting was used in 35% (0-68%) of the plantar fore- or midfoot ulcers. Predictors of use of casting were male gender, large ulcer size and being employed. Vascular imaging was performed in 56% (14-86%) of patients with severe limb ischaemia; revascularization was performed in 43%. Predictors of use of vascular imaging were the presence of infection and ischaemic rest pain. Conclusion Treatment of many patients is not in line with current guidelines and there are large differences between countries and centres. Our data suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot disease.},
  author       = {Prompers, L and Huijberts, M and Apelqvist, Jan and Jude, E and Piaggesi, A and Bakker, K and Edmonds, M and Holstein, P and Jirkovska, A and Mauricio, D and Tennvall, G R and Reike, H and Spraul, M and Uccioli, L and Urbancic, V and Van Acker, K and Van Baal, J and Van Merode, F and Schaper, N},
  issn         = {1464-5491},
  keyword      = {infection,diabetic foot,PAD,deliver of care},
  language     = {eng},
  number       = {6},
  pages        = {700--707},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study},
  url          = {http://dx.doi.org/10.1111/j.1464-5491.2008.02445.x},
  volume       = {25},
  year         = {2008},
}