A retrospective qualitative study on current diabetic foot ulcer management and discussion on extended role of clinical pharmacist
Shankar, M. S. Uma
Lakshmi, K. S.
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Diabetic foot ulcers (DFU) are chronic complications due to poor diabetic control. Diabetic foot ulcers can lead to lifelong disability and substantially diminish the quality of life. The aim of this study was to carry out a thorough evaluation of diabetic foot ulcer management, compare current scenario of DFUs care with the International guidelines and to identify the extended roles of clinical pharmacist to improve the conditions of diabetic patient with foot ulcers. It is a retrospective qualitative study carried out in two tertiary care hospitals of Tamil Nadu state. The patients were selected based on inclusion and exclusion criteria admitted in the hospitals with diabetic foot ulcers. The patient’s sociodemographic and clinical characteristics tools from the patient medication records (PMR) were collected and taken into considerations for the study. The study revealed that diabetic foot ulcer was more prevalent among male patients with type 2 diabetes since 11 to 25 yrs belongs to the age group between 51-60 years. It was found that 60.5% of the patients having at least one co-morbid condition and 90.6% of patients possess one or more risk factors to develop diabetic foot ulcers. Glycated hemoglobin (HbA1c) test were done only by 54.7% of the patients, which showed that it was not insisted as an important identification tool for diabetic foot ulcer. The PMR revealed numerous antibiotics switch-over for the wound treatment as well. From the study it was concluded that an immediate requirement and thorough evaluation of enhanced foot care management, patient centered care and diabetic foot surveillance etc is needed for diabetic foot ulcer management. A comparative current scenario of DFUs care with the International guidelines and its adaptation and modifications according to our need is to be emphasized. Amalgamation of clinical pharmacy services with the multidisciplinary diabetic foot care team services is to be made. The clinical pharmacist’s intervention is to be put forward to improve the conditions of diabetic patient with foot ulcers to decrease the alarming incidences in Indian hospital settings.