Centre for Learning and Discovery, Michael DeGroote Centre for Learning and Discovery, McMaster University, Hamilton, Ontario, Canada.
Division of Vascular Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Can J Diabetes. 2022 Jul;46(5):435-440.e2. doi: 10.1016/j.jcjd.2022.01.004. Epub 2022 Jan 31.
Regular foot screening by a knowledgeable health-care provider is the cornerstone of ulcer and amputation prevention in people with diabetes. However, information on foot screening practices among Canadians with diabetes remains sparse. Therefore, we sought to synthesize available data on the frequency and approach to diabetic foot screening across Canada.
We conducted a scoping review by searching MEDLINE and Embase databases, alongside a grey literature search, for both English- and French-language reports. Data on patients' demographics, setting as well as the frequency of and approach to foot screening were abstracted. Title and abstract screening, full-text review and data abstraction were conducted in duplicate, with discrepancies resolved by a third reviewer.
The search yielded 21 reports including information on diabetic foot screening practices in Canada. In a consolidated study sample of 13,388 Canadians with diabetes, 7,277 (53%) reported receiving a foot examination by a health-care provider at least once in the past year. The majority of reports did not provide information on the demographics of patients being screened or details on the approach to foot screening. No report mentioned the use of a triage algorithm applied to the results of foot screening.
In this work, we identified the limited frequency and uncertain quality of diabetic foot screening across Canada. Further research should focus on better understanding disparities and barriers to regular diabetic foot screening.
由知识渊博的医疗保健提供者定期进行足部筛查是预防糖尿病患者溃疡和截肢的基石。然而,有关加拿大糖尿病患者足部筛查实践的信息仍然很少。因此,我们试图综合加拿大各地有关糖尿病患者足部筛查频率和方法的现有数据。
我们通过搜索 MEDLINE 和 Embase 数据库以及灰色文献搜索,以英文和法文报告的形式进行了范围综述。提取了有关患者人口统计学、环境以及足部筛查频率和方法的数据。标题和摘要筛选、全文审查和数据提取由两名评审员进行,有分歧的地方由第三名评审员解决。
搜索结果产生了 21 份报告,其中包括加拿大糖尿病足部筛查实践的信息。在对 13388 名加拿大糖尿病患者的综合研究样本中,有 7277 名(53%)报告称在过去一年中至少接受过一次医疗保健提供者的足部检查。大多数报告没有提供接受筛查的患者的人口统计学信息或足部筛查方法的详细信息。没有报告提到使用分诊算法应用于足部筛查的结果。
在这项工作中,我们确定了加拿大各地糖尿病足部筛查的频率有限且质量不确定。进一步的研究应侧重于更好地了解定期糖尿病足部筛查的差异和障碍。