A MDT foot intervention in people with diabetes on dialysis

  • Research type

    Research Study

  • Full title

    A Podiatry-led multidisciplinary intervention to reduce the burden of foot disease in people with diabetes and end-stage kidney failure.

  • IRAS ID

    207488

  • Contact name

    Simon Ashwell

  • Contact email

    simon.ashwell@stees.nhs.uk

  • Sponsor organisation

    South Tees Hospitals NHS Fundation Trust

  • Clinicaltrials.gov Identifier

    NCT03054454

  • Duration of Study in the UK

    0 years, 11 months, 28 days

  • Research summary

    Observational studies clearly show that people with diabetes and end-stage kidney failure have an increased risk of foot ulceration and leg amputation. However, there is very little evidence on addressing this problem.

    Diabetes foot care teams have been shown to reduce hospital admissions, length of stay and leg amputation in people with diabetes. Since their introduction at The James Cook University Hospital (JCUH) major diabetes-related leg amputation rates have fallen by 86% (1995 to 2010).

    People with diabetes and end-stage kidney failure require haemodialysis (blood cleaning) 3 times per week for several hours each time. This time commitment makes it difficult to attend other clinical appointments. An audit at JCUH shows that this population fails to attend the normal diabetes foot services.

    This project aims to reduce the incidence of foot disease in people with diabetes and end-stage kidney failure on dialysis. We will set up a podiatry-led intervention within the dialysis unit to prevent and promptly treat foot disease in this population. This will involve foot risk assessment, risk reduction and treatment during dialysis. The intervention will involve diabetes consultants, podiatrists, vascular and orthopaedic surgeons . In this way we hope to reduce leg amputation, hospital admission, procedures to unblock arteries and death in this high risk group.

    The study will run in the dialysis unit at JCUH. Patients will be divided into two groups: those attending for dialysis on a Monday, Wednesday and Friday will form the treatment group and those attending on a Tuesday, Thursday and Saturday will continue to be managed as at present. We will collect data from patient health care records looking in particular at leg amputations, hospital admissions due to foot problems, foot surgery and operations to unblock arteries.

  • REC name

    North East - Tyne & Wear South Research Ethics Committee

  • REC reference

    17/NE/0097

  • Date of REC Opinion

    22 Jun 2017

  • REC opinion

    Further Information Favourable Opinion