ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2006) 12 P54

Prospective analysis of benefits of orthotic interventions in diabetic foot ulcers

N Iqbal, KVC Janaka, E Emmerson, A Fisher, P Kirby, J Innes, B Fairbrother & D Fernando


Sherwood Forest Hospitals NHS Trust, Sutton in Ashfield, United Kingdom.


Background

Inappropriate footwear is a major cause of ulceration in diabetes while good footwear prevents ulceration and recurrence.

Aim

To analyse the benefits of orthotic interventions in foot ulcers in our high risk diabetic patients.

Design and methods

We present preliminary data of a prospective analysis of 18 diabetic patients from our foot clinic to evaluate resource utilisation of orthotic interventions.16 patients were referred for footwear and 15 complied. The frequency of clinic follow up was reduced from 19.2 to 6.1 annually. 8 patients remained free of recurrence and referred to the community podiatry service. If these results were applied to 168 new patients attending foot clinic per year provision of footwear follow up podiatry appointments and review cost could be reduced from £16125 to £5124 annually on wages alone. Each shoe costs £75 with a lifespan of 2 years giving an annual cost of £6300. Provision of shoes would result in a cost reduction of £4701 on podiatry time alone. These figures do not take into account the reductions in cost seen in the reduced recurrence rate for ulcers with ensuing costs of hospital admission and other clinic costs when calculating potential savings. Hence our data underestimate the potential savings.

Conclusion

We conclude that provision of footwear is a cost effective intervention and good shoes did actually benefit our high risk patients. However there is an urgent need for well-designed studies of footwear in both the primary as well as secondary prevention of neuropathic foot ulceration.

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