Exploring Diabetic Foot Exam Performance in a Specialty Clinic

Area of Science:

• Podiatry
• Endocrinology
• Public Health

Background:

• Diabetic foot complications pose a significant risk for amputation.
• Effective prevention strategies rely on early detection through regular foot examinations.
• Patient adherence to self-care practices is vital in managing diabetes-related foot issues.

Purpose of the Study:

• To investigate the link between clinician diabetic foot examination frequency and patient home self-foot examination performance.
• To evaluate clinician adherence to American Diabetes Association (ADA) annual foot examination guidelines.
• To explore associations between patient factors (demographics, beliefs, health literacy, HbA1c) and self-foot exam performance.

Main Methods:

• Utilized a mixed-methods approach combining surveys and retrospective medical record review.
• Assessed the frequency of clinician foot examinations and patient self-foot examination practices.
• Analyzed patient demographic data, health beliefs, literacy, HbA1c levels, and self-management barriers.

Main Results:

• No significant relationship was identified between the frequency of provider foot examinations and patient self-examination rates (N=88).
• Patients not performing daily home self-foot examinations reported a higher prevalence of self-management barriers.
• Only 16% of reviewed patient records met the ADA criteria for a comprehensive annual foot examination.

Conclusions:

• Provider foot examination frequency does not appear to influence patient self-care habits.
• Addressing patient-specific barriers to self-management is essential for improving home foot care.
• Enhancing provider documentation through tools like Electronic Medical Record (EMR) templates and employing motivational interviewing may improve adherence to ADA guidelines and patient outcomes.