Background Diabetic foot ulcers (DFUs) are one of the most common lower extremity complications of diabetes, with the lifetime risk of a patient developing a DFU estimated to be as high as 34%. Annual diabetic foot screening to identify risk factors for diabetic foot ulceration is recommended internationally. This allows for subsequent risk stratification, patient education and provision of appropriate care to prevent progression to ulceration and amputation. Internationally, many regions have some form of a diabetic foot care pathway, but they are not situated within a systematic population health screening programme which can mean many people do not receive an annual screening or are not followed up appropriately. A potential alternative would be to move the diabetic foot care pathway into a systematic and quality assured population health screening programme. However, little work has been carried out to examine the evidence on whether introduction of diabetic foot screening into a population health screening programme is an appropriate course of action to prevent diabetic foot related complications.
Aim The overarching aim is to evaluate and map the evidence on diabetic foot ulcers, and screening for risk factors, using the Wilson and Jungner principles of screening as a framework. In addition, it will evaluate the evidence surrounding the tests that screen for risk factors for diabetic foot ulceration to assess the extent to which they are acceptable or unacceptable for use within a national screening programme.
Methods The review will be conducted in line with the framework by Arksey and O’Malley and the Joanna Briggs Institute. The research questions, and inclusion and exclusion criteria, will be guided by the Wilson and Jungner principles of screening. Once articles have been identified for inclusion, data will be extracted using a pre-specified form. A narrative synthesis approach will be employed to answer the review question. It will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR).
Conclusion We know that patients who receive annual diabetic foot screening have lower incidences of ulcerations and amputations. However, many patients do not receive annual diabetic foot screening or do not receive appropriate follow up due to poorly structured pathways. Findings generated during this scoping review will potentially illustrate whether introduction of diabetic foot screening into a systematic population health screening programme is appropriate and whether certain areas warrant further research.
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