Management of diabetes‐related foot disease in the outpatient setting during the COVID‐19 pandemic

Abstract

The use of telephone and/or video consultation in routine management of acute diabetes-related foot disease (DFD) before the coronavirus disease 2019 (COVID-19) pandemic at a tertiary hospital is unprecedented. In March 2020, the Diabetes Feet Australia (DFA) released a national guideline to inform DFD management during the COVID-19 pandemic. The present study aimed to describe the adherence to the DFA guideline of managing acute DFD using telephone and/or video consultation at a Western Australian tertiary hospital during this period. We found >80% adherence rate to the DFA guideline and the management of active DFD using telephone and/or video consultations was feasible and acceptable in carefully selected patients.Coronavirus disease 2019 (COVID-19) is a highly infectious disease with symptoms ranging from fever and sore throat to severe respiratory illness. 1 COVID-19 was first confirmed in Australia in late January 2020, and by January 2021 there have been >28 000 reported cases and >900 deaths. 2 The pandemic has led to significant stress on hospital systems worldwide and delays to acute hospital care for people with diabetes and diabetes-related complications. 3,4 People with diabetes are at higher risk of COVID-19 and its complications. [3][4][5]

Telemedicine in Vascular Surgery During COVID-19 Pandemic: A Systematic Review and Narrative Synthesis

“…The other four studies were undertaken in Qatar, Australia, Colombia and China14,15,19,22. Eight studies looked at data collected during the early period of the COVID-19 pandemic (between March 2020 to September 2020) 12 , 15 , 16 , 17 , 20 , 21 , 22 , 23 , one study looked at data collected between April and June 2021 19 , and two studies looked at data collected throughout the pandemic 14 , 18 .…”

“…Five studies reported the usage of telemedicine during the pandemic, ranging from 12.6-61% of all outpatient appointment encounters during the study period 12 , 14 , 15 , 19 , 23 . Four studies looked at usage during the early part of the pandemic (all during 2020) 12 , 14 , 15 , 23 .…”

“…Five studies reported the usage of telemedicine during the pandemic, ranging from 12.6-61% of all outpatient appointment encounters during the study period 12 , 14 , 15 , 19 , 23 . Four studies looked at usage during the early part of the pandemic (all during 2020) 12 , 14 , 15 , 23 . Al-Thani, et al reported that in 2020, 61% of all outpatient encounters with a vascular surgeon used telemedicine compared to 0% before the pandemic 14 , whereas Erben, et al reported only 12.6% of 6262 patients encounters were virtual 23 .…”

“…Contractor, et al reported that 178 of the 333 (53.5%) outpatient consultations undertaken in their institution were teleconsultations 12 . Pang, et al reported that out of 157 patients with diabetic foot disease who received outpatient consultations, 33.8% them received at least one virtual consultation 15 . Lopez-Uribe, et al reported that out of 142 outpatient vascular surgery consultation in April to June 2021, 14.8% patients had a virtual appointment either by phone or video call.…”

Telehealth has comparable outcomes to in-person diabetic foot care during the COVID-19 pandemic

“…This can be linked to studies showing increased mortality among telehealth services recipients[ 19 ]. It seems that remote DF care during the COVID-19 pandemic became more effective than before, as shown in a study done in Australia examining the adherence to national DF guidelines and treatment efficacy using telemedicine[ 25 ]. This can be attributed to the accumulated knowledge that helped physicians to avoid mistakes of the past, to the increased familiarization of physicians, patients and caregivers with telehealth during the last two years and to the relatively short - term monitoring time of the studies in comparison with previous research.…”