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A Scoping Review of Foot Screening in Adults With Diabetes Mellitus Across Canada

Published:January 28, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.01.004

      Abstract

      Objectives

      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.

      Methods

      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.

      Results

      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.

      Conclusions

      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.

      Résumé

      Objectifs

      Le dépistage systématique du pied par un professionnel de la santé compétent est le pilier de la prévention de l’ulcère et de l’amputation chez les personnes diabétiques. Toutefois, l’information sur les pratiques de dépistage du pied chez les Canadiens diabétiques demeure fragmentaire. Par conséquent, nous avons cherché à faire la synthèse des données disponibles sur la fréquence et l’approche en matière de dépistage du pied diabétique au Canada.

      Méthodes

      Nous avons consulté les bases de données MEDLINE et Embase, ainsi que la littérature grise, en anglais et en français, pour réaliser l’étude de portée. Nous avons extrait les données démographiques sur les patients, le contexte ainsi que la fréquence et l’approche en matière de dépistage du pied. La vérification des titres et des résumés, l’examen du texte intégral et l’extraction des données ont été effectués en double par 2 membres indépendants, et les divergences, résolues par un 3e examinateur.

      Résultats

      La recherche a permis d’obtenir 21 rapports dans lesquels figurait l’information sur les pratiques de dépistage du pied diabétique au Canada. Dans l’échantillon consolidé d’une étude auprès de 13 388 Canadiens diabétiques, 7277 (53 %) ont signalé avoir eu un examen du pied par un professionnel de la santé au moins une fois au cours de la dernière année. La majorité des rapports n’ont fourni aucune information sur les données démographiques des patients qui avaient eu un dépistage ou des détails sur l’approche du dépistage du pied. Aucun rapport n’a mentionné l’utilisation d’un algorithme de triage appliqué aux résultats du dépistage du pied.

      Conclusions

      Dans ces travaux, nous avons relevé la fréquence limitée et la qualité incertaine du dépistage du pied diabétique au Canada. Des recherches plus approfondies devraient porter sur la meilleure compréhension des disparités et des obstacles en matière de dépistage systématique du pied diabétique.

      Keywords

      Mots clés

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