Establishing a multidisciplinary partnership integrating podiatric care into the Quebec public health-care system to improve diabetic foot outcomes: A retrospective cohort

Effect of contact with podiatry in a team approach context on diabetic foot ulcer and lower extremity amputation: systematic review and meta‐analysis

“…All 23 studies included in the systematic review were in English. We identified 6 studies from the United States [40,45,47,48,54,55], 2 from Canada [44,55] and 10 from Europe, of which 5 were from the United Kingdom [41,43,50,56,57], 2 from Spain [36,38], 1 from Sweden [51], 1 from the Netherlands [58] and 1 from Italy [49]. There were also 3 articles from Asia, of which 2 were from China [42,59] and 1 from Singapore [60].…”

“…In the 12 included studies, podiatric interventions are stated as contact with podiatry [36, 40-42, 45, 49, 51, 55, 58, 59, 61, 63]. Thus, we classified the podiatric interventions as educational strategies [38,43,50,54,57,60], foot care strategies [38,43,46,50,54,56,57,60], offloading strategies [43,46,48,[55][56][57], wound care and infection control strategies [44,48,54], surgical strategies [44,47,54], and stratification [38,42,49]. Only a few studies had defined exposure to the interventions as a weekly exposure to podiatry [56,60], a regular follow-up in podiatry or monthly appointments [38,43,50] or at least every 3 months [57].…”

“…Concerning the role of the podiatrist, we decided a posteriori to distinguish their role according to their implication in the MDT. With this in mind, the podiatrist intervenes in a primary role in 8 articles (leading role or core of the team) [36,43,44,47,48,54,55,59]. Specifically, in these articles, the podiatrist formed the core of the team with endocrinologists [36,59], nurses [43,55], and vascular surgeons [44,47,54].…”

“…Therefore, we retrieved data related to our pre-defined outcomes about DFUs and LEAs as stated in Table 1. All included articles had data concerning primary outcomes: LEAs [36, 38, 41, 54-58, 60, 62, 65] and DFUs [38,54,55,57,58]. With regard to the 11 studies excluded for the meta-analysis, but included in the systematic review (n = 23), 10 out of 11 studies reported data in favour of MDTs including podiatry [40, 42, 44-47, 49-51, 53] and one article reported no effect of the interventions [43].…”

“…Therefore, events of LEAs from exposed group to MDTs and non-exposed group to MDTs were calculated [36,56]. For the remaining pre and post cohort (n = 4) [55,[58][59][60], because of the significant heterogeneity between studies, we decided not to pool the data with association measure. Pre and post cohort MDTs have reported significant results in favour of MDTs to improve DFU healing rate [55,58] and reduce total LEA [58,59] and major LEA [58][59][60].…”