Reducing Lower Extremity Amputations via Peer Support Interventions: A Scoping Review

Area of Science:

• Podiatry
• Public Health
• Behavioral Medicine

Background:

• Diabetes and peripheral artery disease (PAD) significantly increase the risk of lower limb amputation and mortality.
• Peer support interventions are recognized for enhancing diabetes self-management and glycemic control.

Purpose of the Study:

• To conduct a scoping review synthesizing current literature on peer support interventions aimed at reducing lower limb amputations.
• To identify the effectiveness of peer support in improving lower extremity health outcomes for at-risk populations.

Main Methods:

• A comprehensive PubMed search was performed in June 2023, focusing on peer support and individuals with diabetic foot disease and/or PAD.
• Included studies involved peer support interventions for lower extremity health, with outcomes related to lower limb health or program metrics.
• Six studies met the inclusion criteria, categorized into group foot care education (n=4) and group cognitive behavioral studies (n=2).

Main Results:

• Group foot care education studies yielded mixed results, ranging from no effect to significant improvements in foot care and self-management.
• Cognitive behavioral interventions demonstrated a trend toward improved self-management behaviors and physical activity.
• Limited investigations specifically targeting lower extremity outcomes and amputation prevention through peer support were identified.

Conclusions:

• Current evidence suggests peer support interventions hold promise for improving self-management and foot care in high-risk populations.
• Further rigorous research is necessary to establish the conclusive efficacy of peer support in reducing lower limb amputations in patients with diabetes and/or PAD.