A Retrospective Qualitative Study on Current Diabetic Foot Ulcer Management and Discussion on Extended Role of Clinical Pharmacist

Abstract

Diabetic foot ulcers (DFU) are chronic complications due to

poor diabetic control. Diabetic foot ulcers can lead to lifelong

disability and substantially diminish the quality of life. The aim

of this study was to carry out a thorough evaluation of diabetic

foot ulcer management, compare current scenario of DFUs care

with the International guidelines and to identify the extended

roles of clinical pharmacist to improve the conditions of diabetic

patient with foot ulcers.

It is a retrospective qualitative study carried out in two

tertiary care hospitals of Tamil Nadu state. The patients were

selected based on inclusion and exclusion criteria admitted

in the hospitals with diabetic foot ulcers. The patient’s sociodemographic

and clinical characteristics tools from the patient

medication records (PMR) were collected and taken into

considerations for the study.

The study revealed that diabetic foot ulcer was more prevalent

among male patients with type 2 diabetes since 11 to 25 yrs

belongs to the age group between 51-60 years. It was found that

60.5% of the patients having at least one co-morbid condition

and 90.6% of patients possess one or more risk factors to

develop diabetic foot ulcers. Glycated hemoglobin (HbA1c) test

were done only by 54.7% of the patients, which showed that it

was not insisted as an important identification tool for diabetic

foot ulcer. The PMR revealed numerous antibiotics switch-over

for the wound treatment as well.

From the study it was concluded that an immediate requirement

and thorough evaluation of enhanced foot care management,

patient centered care and diabetic foot surveillance etc is

needed for diabetic foot ulcer management. A comparative

current scenario of DFUs care with the International guidelines

and its adaptation and modifications according to our need is

to be emphasized. Amalgamation of clinical pharmacy services

with the multidisciplinary diabetic foot care team services is

to be made. The clinical pharmacist’s intervention is to be put

forward to improve the conditions of diabetic patient with foot

ulcers to decrease the alarming incidences in Indian hospital

settings.

Keywords

• Diabetes,diabetic foot ulcer,wounds,guidelines,clinical pharmacy intervention

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