Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Past health professional attendance for foot care in people with diabetes:  The Foot Disease in Inpatients Study (FDIS) (#360)

Pete A Lazzarini 1 2 , Vanessa Ng 1 3 , Suzanne S Kuys 1 4 , Maarten C Kamp 5 6 , Michael C d'Emden 5 6 , Courtney Thomas 7 , Jude Wills 8 , Ewan M Kinnear 1 3 , Scott Jen 9 , Sheree E Hurn 2 10 , Lloyd Reed 2 10
  1. Allied Health Research Collaborative, Metro North Hospital & Health Service, Brisbane, Qld, Australia
  2. School of Clinical Sciences, Queensland University of Technology, Brisbane, Qld, Australia
  3. Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Qld, Australia
  4. Musculoskeletal Research Program, Griffith University, Gold Coast, Qld, Australia
  5. Department of Endocrinology & Diabetes, Metro North Hospital & Health Service, Brisbane, Qld, Australia
  6. School of Medicine, University of Queensland, Brisbane, Qld, Australia
  7. Department of Podiatry, North West Hospital & Health Service, Mount Isa, Queensland, Australia
  8. Department of Podiatry, Central Queensland Hospital & Health Service, Rockhampton, Queensland, Australia
  9. Department of Podiatry, West Moreton Hospital & Health Service, Ipswich, Queensland, Australia
  10. Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

Background

Guidelines recommend an annual foot screen for people with diabetes and more regular care for those with diabetic foot disease.  Few studies have investigated if people with diabetes are receiving at least annual foot care.   The aim of this paper was to determine the prevalence and correlates of past health professional attendance for foot care in general inpatient populations, and, analyse any differences between diabetes and non-diabetes sub-groups

Methods  

Eligible participants were all adults admitted overnight into five diverse hospitals; excluding maternity, mental health and cognitively impaired. Participants underwent a foot examination to clinically diagnose different active foot disease complications and were surveyed on social determinant, medical history, self-care, foot disease history, and, past health professional attendance for foot care in the year prior to hospitalisation.

Results

Overall, 256 (34.9% (95% CI) (31.6-38.4)) participants had attended a health professional for foot care in the past year from 733 total participants (mean±SD age 62±19 years, 408 (55.8% (52.2-59.4)) were male, 172 (23.5% (20.5-26.7)) had diabetes).  Diabetes populations (58.7%) reported significantly more past foot care than non-diabetes populations (27.6%) (p < 0.001).  In a backwards stepwise multivariate analysis diabetes (OR = 3.04 (2.06-4.47)), arthritis (OR = 1.80 (1.26-2.57)), mobility impairment (OR = 2.00 (1.39-2.89)) and previous foot ulcers (OR = 5.39 (2.92-9.96)) were all independently associated with having attended a health professional for foot care in the year prior to hospitalisation; whilst active foot complications were not (p > 0.05).

Conclusions

These findings suggest one third of all inpatients, and three in five with diabetes, attended a health professional for foot care in the year prior to their hospitalisation.  People with diabetes and previous foot ulcers were much more likely to have attended health professionals for foot care.  Whilst these findings appear encouraging a much more concerted effort is required to ensure people with diabetes are receiving at least annual foot care and those with active foot disease more regular care.