Evidence map›Paper›PMID 32917487›Full record

ArticleJournal of diabetes and its complications2020

Barriers to diabetic foot care in a disadvantaged population: A qualitative assessment.

Maya Fayfman, Marcos C Schechter, Chimora N Amobi, Rebekah N Williams, JoAnna L Hillman, Muhammad Murtaza Alam, Ravi R Rajani, David C Ziemer, Russell R Kempker, Guillermo E Umpierrez

Abstract read
In one paragraph

Article in Journal of diabetes and its complications, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  15. Evaluation and Management of Diabetes-related Foot Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
    Article
  16. Review
  17. Article
  18. Disparities in preventative diabetic foot examination.Seminars in vascular surgery · 2023
    Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Maya FayfmanEmory University School of Medicine, Grady Memorial Hospital, Department of Medicine, Division of Endocrinology, Metabolism, and Lipids, Atlanta, GA, United States of America. Electronic address: maya.fayfman@emory.edu.
Marcos C SchechterEmory University School of Medicine, Grady Memorial Hospital, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, United States of America.
Chimora N AmobiEmory Centers for Training and Technical Assistance, Emory University, United States of America.
Rebekah N WilliamsEmory Centers for Training and Technical Assistance, Emory University, United States of America.
JoAnna L HillmanEmory Centers for Training and Technical Assistance, Emory University, United States of America.
Muhammad Murtaza AlamEmory University School of Medicine, Grady Memorial Hospital, Department of Medicine, Division of Endocrinology, Metabolism, and Lipids, Atlanta, GA, United States of America.
Ravi R RajaniEmory University School of Medicine, Grady Memorial Hospital, Department of Surgery, Division of Vascular Surgery, Atlanta, GA, United States of America.
David C ZiemerEmory University School of Medicine, Grady Memorial Hospital, Department of Medicine, Division of Endocrinology, Metabolism, and Lipids, Atlanta, GA, United States of America.
Russell R KempkerEmory University School of Medicine, Grady Memorial Hospital, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, United States of America.
Guillermo E UmpierrezEmory University School of Medicine, Grady Memorial Hospital, Department of Medicine, Division of Endocrinology, Metabolism, and Lipids, Atlanta, GA, United States of America.

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Translational Research Core - Engagement and Behavior ChangeP30DK111024 · NIDDK · EMORY UNIVERSITY · PI Mohammed Kumail Ali · 2016 to 2026
$13.4M
NCATS NIH HHS UL1 TR000454NCATS NIH HHS UL1 TR002378NIDDK NIH HHS P30 DK111024
6 · The paper itself

Abstract

objectiveWe explored barriers to proper foot care in this population using a qualitative approach with focus group discussions (FGD).

methodsParticipants were recruited from clinics at a safety-net hospital in Atlanta, Georgia and stratified into two groups: diabetic foot ulcer (DFU) and minor amputation (below ankle). The FGDs addressed patient experience in receiving care with a goal of understanding: foot care knowledge, barriers to care, and preferred educational methods. Surveys were performed to supplement FGDs.

resultsForty participants (90% Black) were enrolled. Dominant themes emerging from FGDs were: 1-Patients reported adequate understanding of recommended foot care practices; 2-Personal barriers to self-care included lack of motivation, high cost, poor insurance coverage of supplies, and difficulty limiting activity for proper offloading; 3-Hospital system barriers included difficulty making timely appointments and reaching a provider to arrange care; 4-Access to footcare-related information and services improved with greater disease severity. Participants stressed that improved access often came too late to alter their course. They expressed interest in developing peer support groups to facilitate learning and sharing information relating to DFU.

conclusionWe found that patients with DFU or minor amputations have adequate footcare-related knowledge, but personal and systemic barriers limited appropriate foot care.

Indexed as

Diabetic FootHealth Knowledge, Attitudes, PracticeHealth Services AccessibilityVulnerable PopulationsAmputation, SurgicalDiabetes MellitusFocus GroupsGeorgiaHumansMotivationSafety-net ProvidersSelf CareBarriers to careComplications of diabetesDiabetic foot complicationsDiabetic foot education

Identifiers

PMID32917487
PMCPMC10424493

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.