Open AccessClinical and economic outcomes of a multidisciplinary team approach in a lower extremity amputation prevention programme for diabetic foot ulcer care in an Asian population: A case‐control study
Author(s) -
Lo Zhiwen Joseph,
Chandrasekar Sadhana,
Yong Enming,
Hong Qiantai,
Zhang Li,
Chong Lester Rhan Chaen,
Tan Glenn,
Chan Yam Meng,
Koo Hui Yan,
Chew Tiffany,
Sani Nur Faezah,
Cheong Keet Yeng,
Cheng Leighton Ren Qin,
Tan Audrey Hui Min,
Muthuveerappa Sivakami,
Lai Tina Peiting,
Goh Cheng Cheng,
Ang Gary Y.,
Zhu Zhecheng,
Hoi Wai Han,
Lin Jaime H. X.,
Chew Daniel E. K.,
Lim Brenda,
Yeo Pei Shan,
Liew Huiling
Publication year - 2022
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.13672
Subject(s) - medicine , amputation , diabetic foot , retrospective cohort study , population , cohort , diabetic foot ulcer , cohort study , emergency medicine , prospective cohort study , physical therapy , diabetes mellitus , surgery , environmental health , endocrinology
Present guidelines recommend a multidisciplinary team (MDT) approach to diabetic foot ulcer (DFU) care, but relevant data from Asia are lacking. We aim to evaluate the clinical and economic outcomes of an MDT approach in a lower extremity amputation prevention programme (LEAPP) for DFU care in an Asian population. We performed a case‐control study of 84 patients with DFU between January 2017 and October 2017 (retrospective control) vs 117 patients with DFU between December 2017 and July 2018 (prospective LEAPP cohort). Comparing the clinical outcomes between the retrospective cohort and the LEAPP cohort, there was a significant decrease in mean time from referral to index clinic visit (38.6 vs 9.5 days, P < .001), increase in outpatient podiatry follow‐up (33% vs 76%, P < .001), decrease in 1‐year minor amputation rate (14% vs 3%, P = .007), and decrease in 1‐year major amputation rate (9% vs 3%, P = .05). Simulation of cost avoidance demonstrated an annualised cost avoidance of USD $1.86m (SGD $2.5m) for patients within the LEAPP cohort. In conclusion, similar to the data from Western societies, an MDT approach in an Asian population, via a LEAPP for patients with DFU, demonstrated a significant reduction in minor and major amputation rates, with annualised cost avoidance of USD $1.86m.