A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU)
Background The World Health Organization (WHO) states that diabetic foot ulcers (DFU) are associated with disability, death among patients with diabetes and substantial costs, if not prevented or managed effectively. The aim here is to examine the effectiveness of patient education in preventing...
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| Format: | Article |
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Elsevier
2018
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| Online Access: | https://eprints.nottingham.ac.uk/52093/ |
| _version_ | 1848798646145908736 |
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| author | Adiewere, P. Gillis, Richard B. Imran Jiwani, S. Meal, Andrew Shaw, Ian Adams, Gary G. |
| author_facet | Adiewere, P. Gillis, Richard B. Imran Jiwani, S. Meal, Andrew Shaw, Ian Adams, Gary G. |
| author_sort | Adiewere, P. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
The World Health Organization (WHO) states that diabetic foot ulcers (DFU) are associated with disability, death among patients with diabetes and substantial costs, if not prevented or managed effectively. The aim here is to examine the effectiveness of patient education in preventing and reducing the incidence or recurrence of adult DFU and amputation.
Methods
A systematic review and meta-analysis of randomised clinical trials (RCTs) in adults aged 18+ who have diabetes mellitus (type 1 or type 2) or DFU. CINAHL, EMBASE, MEDLINE, PSYCINFO, Cochrane Library and Evidence-Based Nursing, National Library for Health, Medica and Google Scholar were searched. Only English language studies were considered. Databases were searched from their inception to September 2017.
Findings
Six RCTs met the inclusion criteria. Only five RCTs reported on the incidence of DFU whilst only two reported on amputation rates. There was no advantage of combining different educational approaches in preventing/reducing DFU, relative risk (RR) of 0.50 (95%CI 0.21, 1.17) (P = 0.11). Two RCTs based on foot care education alone were compared with usual care; the result showed a non-significant effect (P = 0.57) with high heterogeneity of 77%.
Analysis based on intensive versus brief educational approach showed a statistically reduced risk of incidence of DFU in the intervention group when compared to the control group; (RR, 0.37, 95%CI 0.14, 1.01) (P = 0.05) with high heterogeneity of 91%.
Interpretation
The intensive educational intervention was associated with reduced incidence of DFU. |
| first_indexed | 2025-11-14T20:23:04Z |
| format | Article |
| id | nottingham-52093 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:23:04Z |
| publishDate | 2018 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-520932020-05-04T19:38:59Z https://eprints.nottingham.ac.uk/52093/ A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) Adiewere, P. Gillis, Richard B. Imran Jiwani, S. Meal, Andrew Shaw, Ian Adams, Gary G. Background The World Health Organization (WHO) states that diabetic foot ulcers (DFU) are associated with disability, death among patients with diabetes and substantial costs, if not prevented or managed effectively. The aim here is to examine the effectiveness of patient education in preventing and reducing the incidence or recurrence of adult DFU and amputation. Methods A systematic review and meta-analysis of randomised clinical trials (RCTs) in adults aged 18+ who have diabetes mellitus (type 1 or type 2) or DFU. CINAHL, EMBASE, MEDLINE, PSYCINFO, Cochrane Library and Evidence-Based Nursing, National Library for Health, Medica and Google Scholar were searched. Only English language studies were considered. Databases were searched from their inception to September 2017. Findings Six RCTs met the inclusion criteria. Only five RCTs reported on the incidence of DFU whilst only two reported on amputation rates. There was no advantage of combining different educational approaches in preventing/reducing DFU, relative risk (RR) of 0.50 (95%CI 0.21, 1.17) (P = 0.11). Two RCTs based on foot care education alone were compared with usual care; the result showed a non-significant effect (P = 0.57) with high heterogeneity of 77%. Analysis based on intensive versus brief educational approach showed a statistically reduced risk of incidence of DFU in the intervention group when compared to the control group; (RR, 0.37, 95%CI 0.14, 1.01) (P = 0.05) with high heterogeneity of 91%. Interpretation The intensive educational intervention was associated with reduced incidence of DFU. Elsevier 2018-05-31 Article PeerReviewed Adiewere, P., Gillis, Richard B., Imran Jiwani, S., Meal, Andrew, Shaw, Ian and Adams, Gary G. (2018) A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU). Heliyon, 4 (5). e00614/1-e00614/20. ISSN 2405-8440 Public health; Health sciences https://doi.org/10.1016/j.heliyon.2018.e00614 doi:10.1016/j.heliyon.2018.e00614 doi:10.1016/j.heliyon.2018.e00614 |
| spellingShingle | Public health; Health sciences Adiewere, P. Gillis, Richard B. Imran Jiwani, S. Meal, Andrew Shaw, Ian Adams, Gary G. A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) |
| title | A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) |
| title_full | A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) |
| title_fullStr | A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) |
| title_full_unstemmed | A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) |
| title_short | A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU) |
| title_sort | systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (dfu) |
| topic | Public health; Health sciences |
| url | https://eprints.nottingham.ac.uk/52093/ https://eprints.nottingham.ac.uk/52093/ https://eprints.nottingham.ac.uk/52093/ |