The Australian Diabetes Foot Registry: From Conceptualisation to National Collaboration

The Australian Diabetes Foot Registry (ADFR) is a national prospective, longitudinal clinical quality registry established in 2020 to standardise data capture and reporting in Interdisciplinary Diabetes High Risk Foot Services. We describe the ADFR's methodology and early implementation outcomes. Stakeholder consultation informed development of the minimum dataset, governance framework and data-capture workflow. Centrally supported ethics and jurisdictional approvals facilitated site onboarding. Clinical, management and outcome data were collected, de-identified and amalgamated in a national repository. Implementation outcomes included recruitment metrics, case ascertainment, mandatory-field missing data, reporting cycles, conference presentations and inaugural report feedback. Seventy-four sites expressed interest and 49 sites completed implementation. Median time from application to commencement was 7 (IQR 4-12) months under a nationally recognised ethics approval. By mid-2025, 10 919 participants were registered, comprising 13 150 care episodes and 22 383 ulcerations. In 2024-2025, mean service-level case ascertainment was 80%, and the mandatory-field missing data rate was 0%-7%. Four annual reporting cycles have been completed, all services strongly endorsed participation after the inaugural report, and data informed 29 conference presentations. The ADFR demonstrates a feasible, scalable national registry model, enabling timely audit and benchmarking and actionable reporting to support quality improvement, research and collaboration.