Evaluation of diabetic foot screening in Primary Care

Endocrinol Nutr. 2014 Jun-Jul;61(6):311-7. doi: 10.1016/j.endonu.2014.01.007. Epub 2014 Feb 25.
[Article in English, Spanish]

Abstract

Aim: To ascertain whether patients with type 2 diabetes are screened for diabetic foot, and to analyze the factors related to patients and centers associated to performance of such screening.

Material and methods: A multicenter, epidemiological, cross-sectional study was conducted. The clinical records of 443 patients with type 2 diabetes monitored at Primary Care for at least 12 months were reviewed. Demographic and healthcare variables and characteristics of the primary care center were recorded.

Results: In the previous year, 51.2% of patients had been trained on foot self-care, 56.4% had undergone foot inspection, 39.5% had been examined with a monofilament, and palpation of peripheral pulses and measurement of the ankle-brachial index were performed in 45.8 and 10.1% of patients, respectively. Diabetic foot screening (inspection, monofilament testing, and palpation of peripheral pulses) was performed in 37% of study patients. Ulcer risk stratification was done in 12.4% of patients. A significant association was found between diabetic foot screening and presence of foot deformities (P<.001), history of neuropathy (P=.005), and history of peripheral artery disease (P<.05). Screening was also associated to some characteristics of the center, such as reception of information about goal achievement (P<.001) and economic incentives for goal attainment (P<.001).

Conclusions: Compliance with diabetic foot screening and ulcer risk stratification in patients with type 2 diabetes in Primary Care was poor.

Keywords: Atención Primaria; Diabetes; Diabetic foot; Pie diabético; Primary Care.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Foot / diagnosis*
  • Diabetic Neuropathies / epidemiology
  • Diabetic Retinopathy / epidemiology
  • Female
  • Foot Deformities, Acquired / epidemiology
  • Goals
  • Health Facilities / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Palpation
  • Patient Education as Topic
  • Physical Examination / statistics & numerical data*
  • Primary Health Care / economics
  • Primary Health Care / methods*
  • Primary Health Care / statistics & numerical data
  • Reflex, Abnormal
  • Risk Assessment
  • Risk Factors
  • Self Care
  • Self-Examination
  • Smoking / epidemiology
  • Spain
  • Touch Perception
  • Vibration