Prevention of amputation by diabetic education

Malone, James M.; Snyder, M E; Anderson, Garry A.; Bernhard, Victor M.; Holloway, Greg; Bunt, T.J.

doi:10.1016/0002-9610(89)90183-9

Cited by 277 publications

(176 citation statements)

References 11 publications

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“…If confirmed, this observation should inform clinical practice and structured foot care education should be adopted as part of the routine management of all patients with a healed foot lesion. The purpose of the present study was to seek to confirm those findings [23] by evaluating the provision of education in the secondary prevention of foot ulcers in patients attending three specialist footcare centres.…”

mentioning

confidence: 74%

“…The education session was delivered to participants in their own homes, with or without their carers, by the researcher (K. A. Radford), who had been specifically trained. The content of the education session was based on the International Consensus on the Diabetic Foot [26], as well as the programme described by Malone and colleagues [23]. The content and wording of the educational material and the style of illustrations was also informed by discussion with a consumer focus group.…”

Section: Methodsmentioning

confidence: 99%

“…Participants were shown illustrations of foot lesions, since the use of illustrations was a feature of the intervention in the study reported by Malone and colleagues [23]. Illustrations included pictures of a foot with poor blood supply, signs of infection, a typical neuropathic ulcer, athlete's foot, Charcot's foot, a gangrenous toe and examples of accidental damage (burnt feet from dozing in front of a fire; a shoe sole penetrated by a nail).…”

Section: Methodsmentioning

confidence: 99%

“…Of 226 patients with healed ulcers who were managed in the UK, 91 (40.3%) developed a recurrent or new ulcer after a median 126 days (range 14-903) [22]. However, only one study of education has specifically targeted patients who had a previous lesion [23]. In that study, 203 patients admitted to hospital for a foot problem (ulcer, amputation, infection) were randomised to receive a single 1-h education session, including graphic images of foot problems, or to receive the usual care.…”

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confidence: 99%

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Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

et al. 2008

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Aims/hypothesis This observer-blind, randomised controlled trial was designed to determine the effect of a foot care education programme in the secondary prevention of foot ulcers. Methods People with newly healed foot ulcers attending one of three specialist clinics were allocated to receive either targeted, one-to-one education or usual care, using a computer-generated random allocation sequence that had been prepared in advance but which was concealed from the clinical researcher. The primary outcome was ulcer incidence at 12 months. Secondary outcomes were ulcer incidence at 6 months and incidence of amputation, mood (Hospital Anxiety and Depression Scale) and quality of life (Diabetic Foot Ulcer Scale) at 6 and 12 months. Protective foot care behaviours (Nottingham Assessment of Functional Footcare) were assessed at 12 months. Results There were 87 (mean [SD] age 63.5 [12.1] years) patients in the intervention group and 85 control patients (mean [SD] age 64.9 [10.9] years). The groups were comparable at baseline. No significant differences (p> 0.05) were observed between groups in ulcer incidence at either 6 months (intervention 30%, control 21%) or 12 months (intervention 41%, control 41%). Recommended foot care behaviours at 12 months were better in the intervention than in the control group (p=0.03), but education had no significant (p>0.05) effect on mood, quality of life or amputations. Conclusions/interpretation Even though the intervention was associated with improved foot care behaviour, there was no evidence that this programme of targeted education was associated with clinical benefit in this population when compared with usual care. The usefulness and optimal delivery of education to such a high-risk group requires further evaluation.

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mentioning

confidence: 74%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

et al. 2008

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“…There is good evidence that simple patient foot care education can reduce ulcers and amputations [40]. Reiber et al found that diabetic patients who did not attend outpatient diabetic education sessions were at increased risk of LEAs [33].…”

Section: Discussionmentioning

confidence: 99%

Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: The Fremantle Diabetes Study

et al. 2006

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Outcome of Diabetic Foot Infections Treated Conservatively

Pittet¹,

Wyssa²,

Herter-Clavel³

et al. 1999

Arch Intern Med

176

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Conservative treatment, including prolonged, culture-guided parenteral and oral antibiotics, is successful without amputation in a large proportion of diabetic patients admitted for a foot skin ulcer or suspected osteomyelitis. Future studies comparing early amputation with novel therapeutic strategies for severe diabetic foot infection should take into account currently identified factors that predicted failure of conservative treatment on admission to the hospital.

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Prevention of amputation by diabetic education

Cited by 277 publications

References 11 publications

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: The Fremantle Diabetes Study

Outcome of Diabetic Foot Infections Treated Conservatively

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