Preventative and early intervention diabetes-related foot care practices in primary care

The aim of this study was to identify current preventative and early intervention diabetes-related foot care practices among Australian primary care healthcare professionals. A survey was developed to obtain information about preventative and early intervention foot care actions, priorities of care, access and referral to expert multidisciplinary foot care teams and adherence to best-practice diabetes-related foot care recommendations. The survey was distributed to GPs and Credentialled Diabetes Educators (CDEs). Surveys were completed by 10 GPs and 84 CDEs. Only 45% of all respondents reported removing the shoes and socks of their patients with diabetes at a consultation. Eighty-one percent of participants reported having access to specialist multidisciplinary foot care teams. Those in urban settings were significantly more likely to report access than those in rural areas (P = 0.04). Median scores indicated that participants did not often utilise specialist teams to refer patients with diabetes-related foot ulceration and Charcot's neuroarthropathy. Only 16% of participants reported having access to specialist foot care telehealth services; patients with diabetes-related foot ulceration and Charcot's neuroarthropathy were rarely referred to these services. This study is the first Australian study to elicit information about preventative and early intervention diabetes-related foot care practices by GPs and CDEs working in Australian primary care. In the presence of acute diabetes-related foot complications, primary healthcare practitioners are not always adhering to best practice foot care recommendations. Further studies are required to understand the reasons for this and ensure evidence-based best practice foot care delivery to people with diabetes.