Evidence-based interventions for identifying candidate quality indicators to assess quality of care in diabetic foot clinics: a scoping review

• Published in: BMC public health Vol. 24; no. 1; pp. 996 - 18
• Main Authors: Lusendi, Flora Mbela, Vanherwegen, An-Sofie, Doggen, Kris, Nobels, Frank, Matricali, Giovanni Arnoldo
• Format: Journal Article
• Language: English
• Published: London BioMed Central 10.04.2024; BioMed Central Ltd; BMC
• Subjects: Accreditation; Amputation; Analysis; Biostatistics; Care and treatment; Collaboration; Data search; Demographic aspects; Diabetes; Diabetes Mellitus; Diabetic foot; Diabetic Foot - diagnosis; Diabetic Foot - therapy; Diabetic foot ulcer; Diagnosis; Environmental Health; Epidemiology; Evidence-Based Medicine; Feet; Foot diseases; Health care expenditures; Health service research; Humans; Indicators; Intervention; Leg ulcers; Medical care; Medical care, Cost of; Medicine; Medicine & Public Health; Meta-analysis; Methods; Patients; Plantar ulcers; Prevention; Public Health; Quality indicators; Quality Indicators, Health Care; Quality management; Quality of healthcare; Ulcers; Vaccine; Vascular diseases; Working groups; Wound Healing; Belgium; United Kingdom > UK; Quality indicators; Health service research; Diabetic foot ulcer; Evidence-based medicine; Quality of healthcare
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-18306-2

Background Foot ulcers in people with diabetes are a serious complication requiring a complex management and have a high societal impact. Quality monitoring systems to optimize diabetic foot care exist, but a formal and more evidence-based approach to develop quality indicators (QIs) is lacking. We aimed to identify a set of candidate indicators for diabetic foot care by adopting an evidence-based methodology. Methods A systematic search was conducted across four academic databases: PubMed, Embase CINAHL and Cochrane Library. Studies that reported evidence-based interventions related to organization or delivery of diabetic foot care were searched. Data from the eligible studies were summarized and used to formulate process and structure indicators. The evidence for each candidate QI was described in a methodical and transparent manner. The review process was reported according to the “Preferred Reported Items for Systematic reviews and Meta-Analysis” (PRISMA) statements and its extension for scoping reviews. Results In total, 981 full-text articles were screened, and 322 clinical studies were used to formulate 42 candidate QIs. Conclusions An evidence-based approach could be used to select candidate indicators for diabetic foot ulcer care, relating to the following domains: wound healing interventions, peripheral artery disease, offloading, secondary prevention, and interventions related to organization of care. In a further step, the feasibility of the identified set of indicators will be assessed by a multidisciplinary panel of diabetic foot care stakeholders.