Observations of teamworking in a multidisciplinary diabetic foot clinic: Bridging roles of podiatry and technology. Diabetic foot ulcer (DFU) is arguably the gravest complication of type 2 diabetes with high disease burden and mortality. Its complexity as a chronic disease with acute presentation necessitates rapid access to a multidisciplinary team (MDT), typically comprising vascular surgeons , endocrinologists and podiatrists. We conducted a focused ethnography of 55 (82.5 h) observations, 10 interviews with patients and several opportunistic in-situ conversations with patients and members of the care team at the multidisciplinary foot clinic of a tertiary public hospital in Singapore. In the clinic, the patient sat in the centre of the treatment room to be attended to by various members of the MDT
Continuing professional development opportunities for Australian endorsed for scheduled medicines podiatrists-What's out there and is it accessible, relevant, and meaningful? A cross-sectional survey. Non-medical prescribing is a valuable strategy to enable equitable access to medications in the context of the increasing demands on health services globally. Australian podiatrists have been able to seek endorsement for scheduled medicines (ESM) for over a decade. This project investigates the perceptions and habits of ESM podiatrists in meeting the extra continuing professional development (CPD) requirements associated with their ESM status. Australian ESM podiatrists completed an anonymous, online survey capturing demographics; CPD engagement; and self-reflections of CPD activities. Twenty
The distribution of registered occupational therapists, physiotherapists, and podiatrists in Australia. In Australia, the distribution of occupational therapists, physiotherapists, and podiatrists density (per 10,000 population) by measure of location/rurality, usual resident population, and area-level socioeconomic status has not been described. To describe the national as well as states -and territories-wide distribution of registered allied health workforce-occupational therapists, physiotherapists, and podiatrists-by measures of rurality and area-level socioeconomic position in Australia. A linked data study that brings together (1) the location of health practitioners' principal place of practice from the Australian Health Practitioner Regulation Agency, (2) a measure of location/rurality
Foot and Ankle Care by Podiatrists and Amputations in Patients With Diabetes and Kidney Failure. Patients with kidney failure have an increased risk of diabetes-related foot complications. The benefit of regular foot and ankle care in this at-risk population is unknown. To investigate foot and ankle care by podiatrists and the outcomes of diabetic foot ulcers (DFUs) in patients with kidney failure. This retrospective cohort study included Medicare beneficiaries with type 2 diabetes receiving dialysis who had a new DFU diagnosis. The analysis of the calendar year 2016 to 2019 data from the United States Renal Data System was performed on June 15, 2023, with subsequent updates on December 11, 2023. Foot and ankle care by podiatrists during 3 months prior to DFU diagnosis. The outcomes were
Health professionals involved in diabetic foot and their tasks in a country without podiatrists: From a Japanese Nationwide Survey. Although there are no podiatrists in 85% of countries worldwide, how diabetic foot is managed in those countries is still unknown. We sought to identify the health professionals involved in diabetic foot and their tasks in Japan, where no podiatrists exist education. In conclusion, the type and proportion of health professionals in our study differed from those in countries with podiatrists, and many performed tasks outside their specialties. This is the first nationwide cross-sectional study of diabetic foot care in a country without podiatrists and is unique in examining multiple specialists/professionals in one study.
A Retrospective Cohort Analysis Comparing the Costs of Ankle Fracture Fixation in Orthopaedics and Podiatry in a U.S. Medicare Limited Data Set. Increasing overlap exists between surgeries performed by podiatrists and orthopaedic surgeons. Large-scale cost comparisons between the two are lacking despite the current climate of cost containment in health care. Using national Medicare data, we aimed to compare per-case Medicare payments between podiatrists and orthopaedic surgeons for ankle fracture fixation. This retrospective cohort study included patients in an outpatient setting undergoing either unimalleolar, bimalleolar, or trimalleolar ankle fracture repair from the national Medicare Limited Data Set (2013-2019). Type of surgeon (podiatrist or orthopaedic surgeon) was determined
device. A cross-sectional observational study design formed the basis for a self-administered online questionnaire. The questionnaire was distributed through podiatry networks based in Australia. Two-hundred and thirty-eight practicing podiatrists participated in this study. Ninety-seven percent of respondents indicated that they would recommend a review appointment after the initial fitting A cross-sectional analysis of podiatrist-initiated review processes after issuing prescribed foot orthoses. Foot orthoses are widely used in clinical practice to treat foot, lower limb and back pathology. As published information guiding the clinical use of foot orthoses is scarce, the aim of this study is to profile the review processes used by practicing podiatrists after issuing an orthotic
Reconstruction of plantar surgical defects with synthetic dermal matrix and split-thickness skin grafts: A case series and functional podiatry outcomes. Reconstruction of surgical defects after wide local excision of acral melanoma on the sole should allow patients to walk and bear weight. Moreover, certain options such as local transposition flaps can compromise follow-up. We present a case
Development of a Motivation Communication Training to Aid Diabetes-Specialist Podiatrists With Adherence Discussions. Diabetic foot ulcers (DFUs) impact a substantial proportion of patients with diabetes, with high recurrence rates, severe complications, and significant financial burden to health care systems. Adherence to treatment advice (e.g., limiting weight-bearing activity) is low with patients reporting dissatisfaction with the way in which advice is communicated. This study aimed to address this problem via the systematic development of a motivation communication training program. The program was designed to support diabetes-specialist podiatrists in empowering patients to actively engage with treatment. The development process followed an intervention mapping approach. Needs
Implementing an integrated diabetic foot care programme in Ireland: podiatrists' experience. International evidence suggests that an integrated multidisciplinary approach to diabetic foot management is necessary to prevent ulceration and progression to amputation. Many health systems have introduced policies or models of care supporting the introduction of this evidence into practice, but little is known about the experiences of those involved in implementation. This study addresses this gap by examining the experiences of podiatrists providing integrated diabetic foot care. Between October 2017 and April 2018, an online survey comprising closed and open-ended questions on podiatrists' demographics, clinical activity, links with other services, continuous professional development activities
Demographic, practice and clinical management characteristics of osteopaths referring to podiatrists: secondary analysis of a nationally representative sample of Australian osteopaths. Interprofessional care is paramount in contemporary healthcare practice. How different professions interact, and the characteristics of those practitioners who practice in an interprofessional way are rarely described in the literature. The aim of the current work was to identify the demographic, practice and clinical management characteristics of Australian osteopaths who report referring to podiatrists. The study was a secondary analysis of data from the Osteopathy Research and Innovation Network (ORION). Inferential statistics were generated to identify statistically significant demographic, practice
Economic value of podiatry service in limb salvage alliance. Over the past decade, multidisciplinary "toe and flow" programs have gained great popularity, with proven benefits in limb salvage. Many vascular surgeons have incorporated podiatrists into their practices. The viability of this practice model requires close partnership, hospital support, and financial sustainability. We intend number of surgeons, podiatry contributed 40% of total wRVUs generated by the entire program in 2019. Despite the fact that that most of the foot and ankle procedures that were regularly performed by vascular surgeons were shifted to the podiatrists, vascular surgeons continued to experience an incremental increase in operative volume and >10% of increase in wRVUs. This study shows that the value
Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial Many patients will seek care from a podiatrist for plantar heel pain (PHP), while few of these patients will also be seen by a physical therapist. Physical therapists can provide treatment that is not a part of routine podiatric care for PHP and may provide additional improvement. Therefore, the purpose of this study was to examine the effects of interdisciplinary care for PHP that incorporated physical therapy treatment after initiating podiatric treatment. Eligible individuals with PHP that presented to a podiatrist were randomized to receive usual podiatric care (uPOD) or usual podiatric care plus physical therapy treatment (uPOD+PT). The primary outcome
Medicare Support for Dental and Podiatry Graduate Medical Education Programs. Oral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce. To examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia. This cross-sectional study was conducted using data from 1252 US teaching hospitals. Data were
An exploration of the use of 3D printed foot models and simulated foot lesions to supplement scalpel skill training in undergraduate podiatry students: A multiple method study. Podiatrists regularly use scalpels in the management of foot pathologies, yet the teaching and learning of these skills can be challenging. The use of 3D printed foot models presents an opportunity for podiatry students to practice their scalpel skills in a relatively safe, controlled risk setting, potentially increasing confidence and reducing associated anxiety. This study evaluated the use of 3D printed foot models on podiatry students' anxiety and confidence levels and explored the fidelity of using 3D foot models as a teaching methodology. Multiple study designs were used. A repeated measure trial evaluated
Podiatry intervention versus usual general practitioner care for symptomatic radiographic osteoarthritis of the first metatarsophalangeal joint: a randomised clinical feasibility study. To determine the feasibility of a clinical trial comparing a podiatry intervention to usual general practitioner (GP) care for people with first metatarsophalangeal (MTP) joint osteoarthritis (OA). A 2-arm , participant- and assessor-blinded, randomized feasibility study was conducted over 12 weeks. Participants were age >40 years and had pain and radiographic OA in the first MTP joint. Participants in the podiatry group had 3 visits and received foot orthoses, exercise, manual therapy, and advice. Participants in the GP group had 1 visit and received medication advice/prescription and the same advice
Simulation Improves Podiatry Student Skills and Confidence in Conservative Sharp Debridement on Feet An essential skill for podiatrists is conservative sharp debridement of foot callus. Poor technique can result in lacerations, infections and possible amputation. This pilot trial explored whether adding simulation training to a traditional podiatry clinical placement improved podiatry student skills and confidence in conservative sharp debridement, compared with traditional clinical placement alone. Twenty-nine podiatry students were allocated randomly to either a control group or an intervention group on day 1 of their clinical placement. On day 4, the intervention group (n = 15) received a 2-hour simulation workshop using a medical foot-care model, and the control group (n = 14) received
Delivery of podiatry care for adults with diabetes or chronic foot conditions: a review of the clinical effectiveness Delivery of podiatry care for adults with diabetes or chronic foot conditions: a review of the clinical effectiveness ..
are best suited to evaluating dexterity in a podiatry student population. A cohort of Novice podiatry students and Experienced podiatrists were recruited and evaluated on a battery of dexterity tests selected to evaluate a variety of different elements. Group differences were evaluated statistically and regression undertaken on significant test outcomes. A total of 108 participants were recruited with 54 Measuring dexterity in the podiatrist population: a cross-sectional comparison of novice students and experienced podiatrists There is no 'gold-standard' for the evaluation of dexterity for the health professional or podiatrist populations. This has resulted in a broad array of generalised tests to evaluate dexterity. Thus, the aim was to determine which objective generalised dexterity tests
Cost-Effectiveness of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People: The REducing Falls with Orthoses and a Multifaceted Podiatry Intervention Trial Findings. Falls are a major cause of morbidity among older people. Multifaceted interventions may be effective in preventing falls and related fractures. To evaluate the cost-effectiveness alongside the REducing Falls with Orthoses and a Multifaceted podiatry intervention (REFORM) trial. REFORM was a pragmatic multicentre cohort randomised controlled trial in England and Ireland; 1,010 participants (> 65 years) were randomised to receive either a podiatry intervention (n = 493), including foot and ankle strengthening exercises, foot orthoses, new footwear if required, and a falls prevention leaflet, or usual