Diabetic Foot Ulcer Clinical Trial
Official title:
Outpatient Nurse Managed Counseling Program for Patients With Diabetic Foot Ulceration
The purpose of the study is to evaluate the effectiveness of a nurse led intervention for
high risk patients with diabetic foot ulceration and/or amputation.
The effectiveness is defined in two ways 1) as a reduction in complication rates (time till
ulceration recurrence, new ulcerations, amputation or reamputation) and 2) as a reduction in
hospital readmissions for foot-related complication (one year survival probability: failure
= readmission for ulceration recurrence, new ulcerations, amputation or re-amputation).
Diabetes mellitus (DM) is associates with numerous complications. One of these is decreased
peripheral circulation impaired sensation leading to the development of foot ulcers that
lead to amputations of toes, feet and limbs. These complications not only have devastating
effects on the individual in terms of loss of functionality but also impact the patient's
ability to carry out and enjoy occupational, recreational and family functioning activities.
Furthermore, foot ulcers and associated problems often lead to prolonged hospitalization and
loss of productivity. All of these have personal as well as societal economical
implications.
This pilot randomized clinical trial (RCT) aims to evaluate the feasibility of an additional
patient education program to current management of foot care in patients with DM.
The study aims to test an alternative to current standard of care for patients with foot
ulcers. A RCT is the preferred method to establish efficacy for this alternative nurse
managed intervention; and if found to be effective, the current study will also allow an
evaluation of the cost effectiveness of this intervention and the potential economic
reduction in cost to the health care system.
The potential implications are major in terms of quality of life, reduction in morbidity in
disability days, and cost savings. It is anticipated that this intervention is at least as
effective as hospital stay, and being surrounded by their own loved ones without the threats
that a hospital setting presents. The findings will be important to consider whether
clinical practice can be changed to benefit patients. If the study results show that the
subjects in the IG have better skills in monitoring and treating their diabetic foot
ulcerations and eventually avoid developing further complications the intervention can be
applied to future patients.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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