Priority 9 from the Foot Health PSP

UNCERTAINTY:How do health professionals prevent/reduce the risk of foot ulceration occurring or getting worse, in patients with diabetes?  (JLA PSP Priority 9)
Overall ranking 9
JLA question ID 0092/9
Explanatory note Strategies to facilitate the reduction of ulcer recurrence, effective ulcer healing interventions and prevention of intial foot ulceration in patients who are high risk, currently have a limited evidence base. In order to understand the complex interventions required and develop more effective prevention strategies, there is a need for studies of higher quality

CD007610 – Hoogeveen et al (2015). Complex interventions for preventing diabetic foot ulceration. Insufficient evidence to show that complex interventions are effective in the prevention of diabetic foot ulceration.        CD001488 – Dorresteijn et al (2014). Patient education for preventing diabetic foot ulceration. Review found limited evidence that patient education alone in the reduction of ulcer and amputation rate.                   CD012835 – McGloin et al (2017). Psychological interventions for treating and preventing recurrence of foot ulcers in people with diabetes. To evaluate the effects of psychological interventions on healing and prevention of recurrence of diabetic foot ulceration.

Health Research Classification System category Generic health relevance 
Extra information provided by this PSP
Original uncertainty examples How do we effectively manage and treat active ulcers in diabetic patients? ~ Will a community  podiatrist in a high risk clinic  who is more of an orthotist help prevent ulcers?  eseentially, what is the relations ship between a service where orthotic advice and appliance are readily available and DFUs?
Submitted by Healthcare Professional x 14, Patient x 7
PSP information
PSP unique ID 0092
PSP name Foot Health
Total number of uncertainties identified by this PSP. 30  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 26 September 2019