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REDUCE

Development of a resource-use measure to capture costs of diabetic foot ulcers

We explored key resources in the management of DFUs to develop and test a participant-reported questionnaire to understand costs and outcomes better.

Diabetic foot ulcers (DFUs) add a significant burden to the lives of people with diabetes in the United Kingdom. They can have a significant impact on a patient's daily life, with treatment requiring frequent changes of dressings and clinic attendances. Nurses and other health professionals within the community provide most wound care at a significant cost.

Methodology

A review of existing research and semi-structured interviews was used to identify the healthcare and non-healthcare resources involved in managing DFUs. A modified Delphi study was then used to reach agreement on which resources were most important to include, using several rounds of questionnaires. The selected items were finally tested in a pilot study to check whether the questionnaire was easy to use and accurately captured resource use.

Findings

The most important resources, identified by 25 healthcare professionals and 6 patients who had or have a DFU, were:

  • Primary care consultations with a podiatrist or orthotist
  • District nurse visits
  • out-of-hours and emergency care
  • scans and investigations
  • consumables provided in clinics

This work has informed the development of a questionnaire looking at resources used, which are considered important by the people most affected by DFUs: patients, family members and carers, and the healthcare professionals key to DFU management.

Patient, carer and family member contribution

Patients were recruited from the REDUCE programme patient and public involvement and engagement (PPIE) group, a selected group of members from the public, including patients, and other diabetes networks. The PPIE group were involved in the development of the research and discussion of the findings.

Read the publication

Cullen K, Jones M, Sheehan C, Game F, Vedhara K, Fitzsimmons D. Development of a resource-use measure to capture costs of diabetic foot ulcers to the United Kingdom National Health Service, patients and society. Journal of Research in Nursing. 2023;28(8):565-578. doi:10.1177/17449871231208108.