Improving Australian rural and remote practitioners’ knowledge of the diabetic foot

New research has been published showing an improvement of Australian rural and remote practitioners’ knowledge of diabetic foot disease. Doctoral candidate Schoen and colleagues from the University of Western Australia investigated differences in a diabetic foot knowledge test before and after an educational session. A total of 246 multidisciplinary health care professionals working in rural and remote Western Australia participated in the study. Knowledge on diabetic foot disease was limited without training, and improved on some, but not all, aspects.

With the lack of available questionnaires, the researchers developed their own questionnaire to assess knowledge, attitudes and practices, based on NHMRC guidelines. This showed use of these guidelines was low (19%). A high risk foot could be adequately identified, however, people at intermediate risk were often incorrectly stratified. This latter finding did not improve after the training. Limitations of the study were the low response rate (with <50% of participants completing both tests) and the use of a knowledge test that was not validated. Longer term follow up testing to investigate if the education resulted in lasting improvements was also not undertaken.

The findings of this study stress the importance of ongoing education for health professionals in rural and remote areas in Australia with regard to diabetic foot disease. It is promising to see that a one-off education session leads to improvements, a finding Jeffcoate and colleagues recently reported as well from a study in various dialysis units. For these improvements to be lasting and to be translated in clinical improvements, ongoing education and support seems an essential strategy to improve diabetic foot care in this challenging environment.