Foot ulcers usually precede lower extremity amputations in many patients, so it is necessary for risks factors to be noted early, so proper prevention measures can be put in place.
Moreover, diabetic neuropathy and lower extremity amputation has been a social problem in the western world as it comprises of a significant component of diabetic related healthcare cost. In order to fight this problem, foot care programs were designed to manage high risk patients. These programs were designed to also teach patients about the progress of the disease and available treatment options. In this study, a nurse-administered foot care programmed was designed based on the International Working Group on the Diabetic Foot (IWGDF)'s risk classification. The design of the study was based on the concepts of disease management which included identification of various signs and symptoms of the disease, assessments, intervention, and outcome evaluation of implemented interventions. The main purpose of this nurse –based intervention was to reduce the occurrence of diabetic foot ulcers in chronic diabetic patients.
Description.
The study included 324 participants who were referred to the program based on their risk status such as peripheral neuropathy, PAD, history of foot ulcers, and amputation (Fujiwara et al, 2011). Patients with orthopedic diseases, neurological disorders, and those on chemotherapy were excluded from the study, which resulted to 88 participants who attended the program for two years (Fujiwara et al, 2011). The participants were divided in groups ranging from Group 0 to Group 3 based on their risk levels. Group 0 comprised of low-risk patients who reported no symptoms of neuropathy, PAD, deformity or history of foot disease. Group 1 patients comprised of the high risk patients who reported some form of neuropathy, but no PAD, deformity or foot pathology. Group 2 patients also comprised of the high risk patients but with more symptoms such as neuropathy, PAD, and deformity, but no foot pathology.