Authors:
Yuki Izumi DPM, Hirotaka Onishi MD, MHPE, PhD, Lawrence A. Lavery DPM, MPH
Published in:
Wound Repair and Regeneration, 2024
Abstract:
The study investigates the management of diabetic foot (DF) care in Japan, a country without podiatrists, using data from a nationwide survey. It identifies the health professionals involved and the tasks they perform, highlighting differences from countries with podiatrists and the broader roles assumed by Japanese health professionals.
Introduction:
Diabetic foot ulcers (DFUs) pose significant health and economic burdens globally. Multidisciplinary teams with podiatrists have proven effective in managing DFUs and reducing amputations. However, many countries lack podiatrists, and there is limited knowledge about DF management in these regions.
Aim:
To identify the health professionals involved in DF care in Japan and analyze their tasks, given the absence of podiatrists.
Methods:
- Data Source: Japanese Nationwide Survey on Foot Ulcer Management.
- Questionnaires: Developed by the Japanese Society for Foot Care and Podiatric Medicine (JFCPM), covering tasks related to DF care.
- Recruitment and Data Collection: Surveys sent to 5071 JFCPM members, with 929 valid responses (249 medical doctors, 680 allied health professionals).
- Statistical Analysis: Tasks performed by each professional were compared within subgroups using SPSS.
Results:
- Primary MDs involved in DF care were plastic surgeons (33.5%), dermatologists (21%), cardiovascular/vascular surgeons (15.2%), and cardiologists (12.1%).
- Nurses were the main allied health professionals (80%), followed by prosthetists/orthotists (7.6%), physical/occupational therapists (5.9%), and clinical engineering technologists (3.6%).
- MDs performed tasks related to their specialties significantly more, but also engaged in tasks outside their specialties.
- Allied health professionals showed similar trends, with clinical engineering technologists notably performing a variety of tasks.
Discussion:
- The types and roles of health professionals in Japan differ from those in countries with podiatrists.
- Many professionals performed tasks beyond their specialty to compensate for the lack of podiatrists.
- The study highlights the importance of interprofessional collaboration and suggests the need for systematic education to ensure comprehensive DF care.
Conclusion:
The first nationwide study in a country without podiatrists, this research identifies the diverse roles and tasks of health professionals involved in DF care in Japan. It underscores the need for an organized multidisciplinary approach tailored to the country’s specific context.
References:
Key references include studies on the burden of DFUs, effectiveness of multidisciplinary teams, and global guidelines on DF management. Notable citations are Armstrong et al., 2017; Edmonds et al., 2021; Khan & Sapsed, 2017; Blanchette et al., 2020.
For detailed reading, access the article here.
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