Standard Care vs Telemedicine for Diabetic Foot Ulcer Follow-up Care

Telemedicine follow-up for patients with diabetes-related foot ulcers might not be an inferior follow-up method compared with standard outpatient care, according to a study published in Diabetes Care.

Researchers identified 182 adults at 3 clinical sites in Norway to participate in a prospective randomized controlled 12-month trial to determine “whether telemedicine follow-up of patients with diabetes-related foot ulcers in primary health care in collaboration with specialist health care was noninferior to standard outpatient care for ulcer healing time.”

Participants were randomly assigned to receive either standard outpatient care (n=88) or telemedicine (n=94) follow-up for up to a maximum of 12 months.

Study results found telemedicine to be noninferior to standard outpatient care with regard to healing time (mean difference: –0.43 months; 95% CI, –1.50 to 0.65), number of deaths, number of consultations, and overall patient satisfaction. There were significantly fewer amputations (both major and minor) in the telemedicine treatment group (mean difference: –8.3%; 95% CI, –16.3% to –0.5%), as well as fewer consultations per month (mean difference: –1.1; 95% CI, –2.2 to –0.1).

Researchers concluded that telemedicine is noninferior to standard of care for follow-up care of diabetes-related foot ulcers in primary health care, with no difference in patient satisfaction.

Therefore, this is a valid, reliable, relevant, and effective resource clinicians may use to conserve medical personnel resources while maintaining close follow-up in patients who are local as well as distant to medical clinics. 

Reference

Smith-Strøm H, Igland J, Østbye T, et al.  The effect of telemedicine follow-up care on diabetes-related foot ulcers: a cluster randomized controlled noninferiority trial [published online November 29, 2017]. Diabetes Care. doi:10.2337/dc17-1025/-/DC1