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Table 4 Assessment of Moderate Risk – Characteristics of Sites

From: Organizational changes in diabetic foot care practices for patients at low and moderate risk after implementing a comprehensive foot care program in Alberta, Canada

Have a formalized clinic20142019P-value
YesNo YesNo  
ZoneNN% YesNN% Yes 
 North11282856450.30
 Edmonton111248117610.53
 Central5122974640.12
 Calgary3175510330.26
 South483362750.17
 Federal or provincial01020100ND
 Total346235362955See Table 2
 Non-respondents810 
Area of practice (more than 1 answer possible)
 Primary or family practice10953137650.52
 Outpatient4142274640.048
 Acute care5132833500.362
 Wound clinic41127601000.004
 Homecare, long-term care82822910470.07
 Community care6103834431.00
 Other527143571.00
Type of service (more than 1 answer possible)
 HRFT 13  
 Hospital/clinic team25 20  
 Home care5 4  
 See referrals4 2  
Services provided (more than one answer possible) 
Skin & nail abnormalitiesN [%]N [%] 
  Total number of sites (formalized and unformalized clinics)9639 
  Skin or nail care provided44 [46]21 [54]0.45
  Provide list of foot/nail care providers in the community33 [34]26 [67]0.001
  Refer to podiatrist or footcare nurse33 [34]29 [74]< 0.001
  Refer to HRFT11 [28]
  None of the above8 [8]1 [3]
  Other2 [2]3 [8]
Structural deformities (bunions, hammertoes)
  Total number of sites95 [100]39 
  Provide education regarding self-management47 [49]30 [77]0.004
  Refer to podiatrist or orthopedics63 [66]31 [79]0.007
  Other13 [14]3 [8]ND
  None of the above12 [13]0ND
Footwear problems
  Total number of sites / no answer9639 
  Provide information/education regarding appropriate footwear selection76 [79]35 [90]0.22
  Refer to HRFT18 [46]
  Refer for footwear / orthotics through AADL50 [52]20 [51]1.00
  Refer for footwear / orthotics without AADL authorization26 [27]14 [36]0.31
  None of the above7 [7]1 [3]ND
  Other20 [21]4 [10]ND
Services provided for vascular problems
 Total number of sites96 [100]39 
 Perform vascular (lower limb) assessment62 [65]36 [92]0.001
 Refer to HRFT19 [49]
 Refer to GP for assessment36 [38]23 [59]*0.035
 Refer to vascular lab for assessment24 [25]15 [38]0.14
 Other13 [14]4 [10]ND
If vascular assessment performed, procedures usedOut of 62Out of 36 
   ABPI44 [71]16 [44]0.011
   PPG (toe pressures)37 [60]17 [47]0.29
   ABPI + PPG (gold standard)32 [52]14 [39]0.29
   Pedal pulses38 [61]34 [94]< 0.001
   Other4 [6]5 [14]ND
   Refer to HRFT17 [47]
Services provided for loss of sensation / neuropathic painOut of 91Out of 39 
 Refer to MD/NP for treatment of neuropathic pain83 [91]28 [72]**0.007
 Refer to HRFT18 [46]
 Address neuropathic pain in their clinic6 [7]5 [13]0.30
 Other2 [2]1 [3]ND
 None02 [5]ND
Frequency of reassessing patients with moderate risk
 1–3 months15 [16]8 [21]0.62
 4–6 months11 [12]11 [28]0.039
 7–12 months8 [8]3 [8]1.00
 No formalized schedule48 [53]7 [18]< 0.001
 Other7 [8]9 [23]ND
  1. Statistical analysis used Fisher’s Exact Test
  2. Abbreviations: ABPI Ankle-brachial pressure index, AADL Alberta Aids to Daily Living, GP General practitioner, HRFT High risk foot team, MD Medical doctor, NP Nurse practitioner, PPG Photoplethysmography toe pressure, ND Not done