Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jan 13;14(1):6.
doi: 10.1186/s13047-020-00445-5.

Nature and extent of outpatient podiatry service utilisation in people with diabetes undergoing minor foot amputations: a retrospective clinical audit

Clare Linton  1   2   3 , Angela Searle  4 , Fiona Hawke  4 , Peta Ellen Tehan  4 , Vivienne Chuter  4
Affiliations
Review

Nature and extent of outpatient podiatry service utilisation in people with diabetes undergoing minor foot amputations: a retrospective clinical audit

Clare Linton et al. J Foot Ankle Res. .

Abstract

Background: People with diabetes are at high risk of foot complications that can lead to lower extremity amputations. National standards suggest that early assessment and management by a podiatry led multidisciplinary high-risk foot clinic (HRFC) helps to reduce complications. This review is a retrospective audit of the Central Coast Local Health District (CCLHD) podiatry department service utilisation in people with diabetes who had undergone a minor foot amputation.

Methods: All people with diabetes who had minor foot amputations in the calendar year 2017 in the CCLHD in New South Wales were identified. Podiatry occasions of service from all podiatry service clinics (e.g. general, orthoses, wound, HRFC) and hospital stays for 12 months prior to, and 12 months, post the minor foot amputation were extracted.

Results: Data on 74 people with diabetes who underwent 85 minor foot amputations were collected. In the 12-month period leading up to their minor foot amputation less than half, 42% (n=31), of the patients had attended any of the available podiatry service clinics within the CCLHD system. Post-amputation and discharge from hospital there was an overall rise of 26% in numbers attending all CCLHD podiatry- led clinics bringing the total to 68% (51). However, attendance at the HRFC rose by only 2% from 16% (n=12) to 18% n= (13).

Conclusion: This study shows that there was underutilisation of Podiatry Services in the CCLHD in 2017 with some participants not meeting national treatment guidelines for foot health services. Revision of current referral pathways both prior to, during and following hospitalisation and expanding the multidisciplinary HRFC to accommodate the population by providing more accessible locations has since been undertaken to increase service access. Further provision of education to those highlighted to be at high risk has also been implemented.

Keywords: Diabetes; High risk foot clinic; Minor foot amputation; Podiatry.

PubMed Disclaimer

Conflict of interest statement

No competing interests.

Figures

Figure 1
Figure 1
Characteristics of the study population. Pre and Post amputation numbers do not include patients who attended only a single appointment prior to (n=2) or post (n=1) their amputation
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. National Institute for Health and Care Excellence NICE. Diabetic foot problems: prevention and management. UK: NICE guideline; 2015. - PubMed
    1. Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Hinchliffe RJ, Lipsky BA. In: IWGDF Guidelines on the prevention and management of diabetic foot disease, in Practical Guidelines, v.N. Schaper NC, Jaap J, Apelqvist J, Bus SA, Robert J, Benjamin H, Lipsky A, editors. 2019. - PubMed
    1. Diabetic Foot Australia, Australian and International Guidelines on Diabetic foot disease . IWGDF recomendations on peripheral artery disease and infection. West End Queensland: Diabetic Foot Australia; 2016. p. 31.
    1. National Health & Medical Research Council (NHMRC) In: National Evidence-based Guideline on prevention ,Identification and Management of Foot Complications in Diabetes in Guideline on Management of Type 2 Diabetes. Heart MBIDI, editor. Melbourne: Diabetes Institute; 2011.
    1. Lazzarini PA, O'Rourke SR, Russell AW, Derhy PH, Kamp MC. Reduced incidence of foot-related hospitalisation and amputation amongst persons with diabetes in Queensland, Australia. PLoS One. 2015;10(6). - PMC - PubMed