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Our primary research question is whether healing time (within 12 months) of diabetes-related foot ulcers treated in primary care in collaboration with telemedicine consultations with a hospital outpatient is no worse than with standard hospital outpatient care.
Clipp store 2016 trial#
The main aim of this trial is to evaluate whether follow-up of patients with diabetes-related foot ulcers in primary care, in collaboration with hospital outpatient specialist care, is noninferior to standard outpatient care in terms of ulcer healing time.
Clipp store 2016 professional#
These qualitative studies are part of a larger program supported by the Norwegian Research Council (DiaHEALTH-221065/F40) to promote patient and professional competencies in diabetes care and management. In addition, qualitative data were collected to evaluate ongoing processes and further elaborate the experiences of patients and health care professionals during the intervention period.
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The trial is designed to compare the effect of telemedicine follow-up in primary care to standard hospital outpatient care on ulcer healing time. This paper presents the protocol for an ongoing cluster randomized controlled noninferiority trial, DiaFOTo (Diabetic Foot and Telemedical Images Project). This project is expected to increase the focus on research related to integrated care. Therefore, there is a need for such studies to document the safety and effectiveness of a telemedicine-based follow-up. To date, randomized controlled studies have not confirmed that telemedicine follow-up care for patients with diabetes-related foot ulcers results in equivalent healing time when compared with standard outpatient care in specialist health care. Patients with diabetes foot ulcers are prone to adverse outcomes because of rapid deterioration of the ulcer or the onset of infection. Qualitative studies of diabetes-related foot ulcers have shown that using telemedicine can result in follow-up care of similar quality to standard outpatient care while at the same time enabling more flexible organization and greater patient satisfaction. In this reform, electronic communication and use of telemedicine is emphasized.
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The main goal for the Norwegian Coordination Reform in the health care sector in January 2012 was to obtain coordinated and integrated health care for patients, especially for those with complex conditions. State of the Evidence, Relevance, and Innovation Potential It is therefore important to start treatment early and have a close, well-organized follow-up for patients with diabetes-related foot ulcers to improve the management of the diabetic foot. The cost of treating foot ulcers is also considerable. Other studies have shown that a foot ulcer is associated with reduced quality of life, social limitations, and pain. An epidemiologic study of diabetes-related foot ulcers among community-dwelling adults and older people based on data from the Nord-Trøndelag Health Study (HUNT2) showed that a history of foot ulcer was significantly associated with increased mortality and that about 10% of people with diabetes reported a history of foot ulcer. The increasing prevalence of diabetes, especially type 2 diabetes, combined with an increasing proportion of older people in the population present great challenges for the health care services. In addition, an estimated 150,000 people have undiagnosed type 2 diabetes. In Norway, about 200,000 people have been diagnosed with diabetes with an annual increase of 8000 to 10,000 forecast. The prevalence of diabetes is expected to increase both in Norway and globally.