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Delayed referral of patients with diabetic foot ulcers across Europe : Patterns between primary care and specialised units

Manu, Chris ; Lacopi, Elisabetta ; Bouillet, Benjamin ; Vouillarmet, Julien ; Ahluwalia, Raju ; Lüdemann, Claas ; Garcia-Klepzig, José Luis ; Meloni, Marco ; De Buruaga, Víctor Rodriguez Saenz and Sánchez-Ríos, Juan Pedro , et al. (2018) In Journal of Wound Care 27(3). p.186-192
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... (More)

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 1328% 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 5566% 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.

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Contribution to journal
publication status
published
subject
keywords
diabetic foot, Europe, primary care, referral, ulceration
in
Journal of Wound Care
volume
27
issue
3
pages
7 pages
publisher
Emap Healthcare Limited
external identifiers
  • pmid:29509115
  • scopus:85043381612
ISSN
0969-0700
DOI
10.12968/jowc.2018.27.3.186
language
English
LU publication?
no
id
c2718f70-29ef-46a9-8f34-8ad2a2c31bb7
date added to LUP
2018-03-28 12:00:26
date last changed
2020-01-16 03:17:53
@article{c2718f70-29ef-46a9-8f34-8ad2a2c31bb7,
  abstract     = {<p>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 1328% 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 5566% 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.</p>},
  author       = {Manu, Chris and Lacopi, Elisabetta and Bouillet, Benjamin and Vouillarmet, Julien and Ahluwalia, Raju and Lüdemann, Claas and Garcia-Klepzig, José Luis and Meloni, Marco and De Buruaga, Víctor Rodriguez Saenz and Sánchez-Ríos, Juan Pedro and Edmonds, Mike and Apelqvist, Jan and Martinez, Jose Luis Lazaro and Van Acker, Kristien},
  issn         = {0969-0700},
  language     = {eng},
  month        = {03},
  number       = {3},
  pages        = {186--192},
  publisher    = {Emap Healthcare Limited},
  series       = {Journal of Wound Care},
  title        = {Delayed referral of patients with diabetic foot ulcers across Europe : Patterns between primary care and specialised units},
  url          = {http://dx.doi.org/10.12968/jowc.2018.27.3.186},
  doi          = {10.12968/jowc.2018.27.3.186},
  volume       = {27},
  year         = {2018},
}