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. 2020 Apr 30;15(4):e0232395.
doi: 10.1371/journal.pone.0232395. eCollection 2020.

Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

Taylor-Jade Woods  1 , Fisaha Tesfay  1 , Peter Speck  2 , Billingsley Kaambwa  1
Affiliations

Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

Taylor-Jade Woods et al. PLoS One. .

Abstract

Background: Diabetic foot ulcer (DFU) is a severe complication of diabetes and particularly susceptible to infection. DFU infection intervention efficacy is declining due to antimicrobial resistance and a systematic review of economic evaluations considering their economic feasibility is timely and required.

Aim: To obtain and critically appraise all available full economic evaluations jointly considering costs and outcomes of infected DFUs.

Methods: A literature search was conducted across MedLine, CINAHL, Scopus and Cochrane Database seeking evaluations published from inception to 2019 using specific key concepts. Eligibility criteria were defined to guide study selection. Articles were identified by screening of titles and abstracts, followed by a full-text review before inclusion. We identified 352 papers that report economic analysis of the costs and outcomes of interventions aimed at diabetic foot ulcer infections. Key characteristics of eligible economic evaluations were extracted, and their quality assessed against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

Results: 542 records were screened and 39 full-texts assessed for eligibility. A total of 19 papers were included in the final analysis. All studies except one identified cost-saving or cost-effective interventions. The evaluations included in the final analysis were so heterogeneous that comparison of them was not possible. All studies were of "excellent", "very good" or "good" quality when assessed against the CHEERS checklist.

Conclusions: Consistent identification of cost-effective and cost-saving interventions may help to reduce the DFU healthcare burden. Future research should involve clinical implementation of interventions with parallel economic evaluation rather than model-based evaluations.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) flow diagram showing study selection process.
DFU: diabetic foot ulcer.
See this image and copyright information in PMC

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