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Delivery of Podiatry Care for Adults with Diabetes or Chronic Foot Conditions: A Review of the Clinical Effectiveness

Published on: November 6, 2013
Project Number: RC0492-000
Product Line: Rapid Response
Report Type: Summary with Critical Appraisal
Result type: Report

Report in Brief

Context
Podiatry is a field of medicine that focuses on preventing, diagnosing, and treating conditions associated with the foot and ankle. Common chronic foot conditions for those with diabetes include ulcers, poor circulation, nail issues, skin rashes, loss of sensation, and weight-bearing imbalances. Amputation of a foot or leg is a complication of diabetes that most often begins with a foot ulcer.

Technology
While licensing requirements do vary from province to province, podiatrists ― or Doctors of Podiatric Medicine ― are highly trained practitioners. In Ontario, podiatrists are authorized to communicate a diagnosis, perform surgical procedures, administer injections into the feet, and prescribe medication. Currently, there is no certification process for foot care nursing in Canada.

Issue
The number of podiatrists in Canada is small. For example, there are 70 podiatrists working in Alberta, 70 in Ontario, and 80 in British Columbia. Family physicians, nurses, and other allied health professionals also provide routine foot care. As the number of Canadians with diabetes is growing each year, an increased demand for foot care can be expected. Is there clinical evidence to support the delivery of foot care by podiatrists, as compared with other health professionals?

Methods
A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs).

Results
The literature search identified 174 citations, with no additional articles identified from other sources. After screening the abstracts, no potentially relevant studies were selected for full-text review, nor did any meet the criteria for inclusion in this review.

Key Messages

  • No clinical evidence was found comparing the delivery of foot care by a podiatrist with delivery by other health professionals.
  • Diabetic foot care by an interdisciplinary team has been shown to have a positive impact.
  • As the incidence of diabetes grows, research into the optimal delivery of foot care for adults with diabetes may be warranted.

Question

  1. What is the clinical evidence regarding the delivery of foot care by podiatrists compared to nurses or allied health professionals for adults with diabetes or chronic foot conditions?
  2. What is the clinical evidence regarding the delivery of foot care by podiatrists compared to non-specialist physicians for adults with diabetes or chronic foot conditions?
  3. What is the clinical evidence regarding the delivery of foot care by nurses or allied health professionals compared to non-specialist physicians for adults with diabetes or chronic foot conditions?

Key Message

No evidence was identified regarding the delivery of foot care by different health professionals.

Tags

chiropody, diabetic feet, nursing, nurses, patient care team, physicians, family, podiatry, allied health occupations, foot ulcer, diabetic foot, diabetes, other miscellaneous topics, chiropodist, chiropodists, podiatrist, podiatrists, Foot care, foot ulcers, Nurse, all