Diabetic Foot and COVID-19 Pandemic in Argentina: Foot and Ankle Specialists Respond to the Use of Telemedicine
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Published:
Feb 17, 2023
Keywords:
Telemedicine, foot and ankle, diabetic foot, traumatology, COVID-19 pandemic
Main Article Content
Abstract
Introduction: Telemedicine was the recommendation of international societies during the COVID-19 pandemic for medical consultations in patients with diabetic foot (DF). The main aim of this work is to evaluate the use of telemedicine as a tool for the evaluation and follow-up of patients with DF by foot and ankle specialists in Argentina. As secondary objectives, we propose to assess the satisfaction perceived by the professionals with the use of this tool, to evaluate the specific strategies used to carry out the remote medical consultation, and to determine its permanence when returning to the usual care activity.
Materials and Methods: Three surveys were sent to members of the Argentine Society of Medicine and Surgery of the Leg and Foot in May and July 2020 and April 2022.
Results: According to 75% of respondents, the most valuable function of telemedicine was prevention, followed by monitoring of the clinical pathology (54.1%), postoperative follow-up (41.6%), and diagnosis (29.1%). The most commonly used resources for remote consultation were telephone conversations, followed by images sent by instant messaging. Only 37.5% used electronic health record platforms during 2020.
Conclusions: The most commonly used resources for remote consultation were telephone conversations, followed by images sent by instant messaging. 33.4% of respondents were satisfied with telemedicineconsultations in May 2020, while in July, satisfaction with this tool rose to 46.7%. In April 2022, only 13% of those surveyed in July 2020 continued offering remote consultations.
Materials and Methods: Three surveys were sent to members of the Argentine Society of Medicine and Surgery of the Leg and Foot in May and July 2020 and April 2022.
Results: According to 75% of respondents, the most valuable function of telemedicine was prevention, followed by monitoring of the clinical pathology (54.1%), postoperative follow-up (41.6%), and diagnosis (29.1%). The most commonly used resources for remote consultation were telephone conversations, followed by images sent by instant messaging. Only 37.5% used electronic health record platforms during 2020.
Conclusions: The most commonly used resources for remote consultation were telephone conversations, followed by images sent by instant messaging. 33.4% of respondents were satisfied with telemedicineconsultations in May 2020, while in July, satisfaction with this tool rose to 46.7%. In April 2022, only 13% of those surveyed in July 2020 continued offering remote consultations.
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How to Cite
Parise, A. C., Coria, H. E., López, V., & Santini Araujo, M. G. (2023). Diabetic Foot and COVID-19 Pandemic in Argentina: Foot and Ankle Specialists Respond to the Use of Telemedicine. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(1), 45-52. https://doi.org/10.15417/issn.1852-7434.2023.88.1.1623
Section
Clinical Research
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https://doi.org/10.12968/jowc.2014.23.Sup5b.S1
25. Fasterholdt I, Gerstrøm M, Rasmussen BSB, Yderstræde KB, Kidholm K, Pedersen KM. Cost-effectiveness of
telemonitoring of diabetic foot ulcer patients. Health Informatics J 2018;24(3):245-58. https://doi.org/10.1177/1460458216663026
26. Smith-Strøm H, Igland J, Østbye T, Tell GS, Hausken MF, Graue M, et al. The effect of telemedicine follow-up care on diabetes-related foot ulcers: A cluster-randomized controlled noninferiority trial. Diabetes Care 2018;41(1):96-103. https://doi.org/10.2337/dc17-1025
27. Yderstraede KB, Froekjaer J, Rasmussen BSB. Response to Comment on Rasmussen et al. A randomized controlled trial comparing telemedical and standard outpatient monitoring of diabetic foot ulcers. Diabetes Care 2015;38:1723-9. Diabetes Care 2016;39(1):e11. https://doi.org/10.2337/dci15-0018
28. Al-Sofiani ME, Alyusuf EY, Alharthi S, Alguwaihes AM, Al-Khalifah R, Alfadda A. Rapid implementation
of a diabetes telemedicine clinic during the coronavirus disease 2019 outbreak: Our protocol, experience, and
satisfaction reports in Saudi Arabia. J Diabetes Sci Technol 2020;1932296820947094. https://doi.org/10.1177/1932296820947094
en: https://www.boletinoficial.gob.ar/detalleAviso/primera/227042/20200320
2. Usuelli FG, D’Ambrosi R. Being a foot and ankle surgeon in Italy in the era of COVID-19. Knee Surg Sports
Traumatol Arthrosc 2020;28(6):1679-82. https://doi.org/10.1007/s00167-020-06024-2
3. Feeleya I, McAleesea T, Cleshama K, Moloneya D, Crozier-Shawa G, Hughesa A, et al. Foot and ankle service
adaptation in response to COVID-19 and beyond. Ann Med Surg (Lond) 2020;54:62-4. https://doi.org/10.1016/j.amsu.2020.04.023
4. Rogers LC, Lavery LA, Joseph WS, Armstrong DG. All feet on deck-The role of podiatry during the COVID-19
pandemic. J Am Podiatr Med Assoc 2020. https:/doi.org/10.7547/20-051
5. Ryu S. Telemedicine: Opportunities and developments in member states: Report on the Second Global Survey on eHealth 2009 (Global Observatory for eHealth Series, Volume 2). Health Inform Res 2012;18(2):153-5.
https://doi.org/10.4258/hir.2012.18.2.153
6. COVID-19 and Diabetic Foot Disease. IWGDF Guidelines. Disponible en: https://iwgdfguidelines.org/covid-19/
[Consulta: octubre 2020]
7. Hazenberg CEVB, Aan de Stegge WB, Van Baal SG, Moll FL, Bus SA. Telehealth and telemedicine applications for the diabetic foot: A systematic review. Diabetes Metab Res Rev 2020;36(3):e3247. https://doi.org/10.1002/dmrr.3247
8. Bates M, Edmonds M, Kavarthapu V, Manu C, Rashid H, Vas P. Diabetes foot care in the COVID-19 pandemic.
Diabetic Foot Clinic, King’s College Hospital, London, UK. Disponible en:
https://www.d-foot.org/images/pdf-article-kings.pdf [Consulta: abril 2020]
9. Lurie N, Carr BJ. The role of telehealth in the medical response to disasters. JAMA Intern Med 2018;178(6):745-6. https://doi.org/10.1001/jamainternmed.2018.1314
10. Hospital de Pediatría “Prof. Dr. Juan P. Garrahan”. Comunicación y Telemedicina. Disponible en:
https://www.garrahan.gov.ar/comunicacion-y-telemedicina/contenidos/comuncacion-y-telemedicina [Consulta:
diciembre 2020]
11. Ministerio de Salud y Desarrollo Social de la Nación. Secretaría de Gobierno de Salud. Resolución N.° 21/2019.
Disponible en: https://www.boletinoficial.gob.ar/detalleAviso/primera/199759/20190109 [Consulta: diciembre 2020]
12. Whitman E. Muros que se transformaron en océanos en manos de la telemedicina. Revista de la Asociación
Interdisciplinaria Argentina de Cicatrización de Heridas 2019;5(8):43-5. Disponible en:
https://www.aiach.org.ar/wp-content/uploads/2020/07/muros-n8.pdf
13. Debernardi ME, Bordón MP, Campastri A, Chequim A, Cilio AM, Fava MV, et al. Teledermatología en pandemia de COVID-19 en un hospital público. Medicina (B Aires) 2020;80(Supl. 6):18-24. PMID: 33481728
14. Moreno MR. Datos médicos e historia clínica. Secreto médico. Confidencialidad. Diccionario Enciclopédico de la Legislación Sanitaria Argentina. Disponible en:
http://www.salud.gob.ar/dels/entradas/datos-medicos-e-historia-clinica-secreto-medico-confidencialidad [Consulta: diciembre 2020]
15. Ley 25.326 de Protección de los datos personales. Boletín Oficial de la República Argentina 02-Nov-2000.
Disponible en: https://www.boletinoficial.gob.ar/detalleAviso/primera/202373/20190226 [Consulta: diciembre 2020]
16. Mars M, Morris C, Scott RE. WhatsApp guidelines – what guidelines? A literature review. J Telemed Telecare
2019;25(9):524-9. https://doi.org/10.1177/1357633X19873233
17. Ellanti P, Moriarty A, Coughlan F, McCarthy T. The use of WhatsApp Smartphone Messaging improves
communication efficiency within an orthopaedic surgery team. Cureus 2017;9(2):e1040. https://10.7759/cureus.1040
18. Shin L, Bowling FL, Armstrong DG, Boulton AJM. Saving the diabetic foot during the COVID-19 pandemic: A tale of two cities. Diabetes Care 2020;43(8):1704-9. https://doi.org/10.2337/dc20-1176
19. Jaly I, Iyengar K, Bahl S, Hughes T, Vaishya R. Redefining diabetic foot disease management service during
COVID-19 pandemic. Diabetes Metab Syndr 2020;14(5):833-8. https://doi.org/10.1016/j.dsx.2020.06.023
20. Liu C, Shi WL, You JX, Li HY, Li L. An internet-based algorithm for diabetic foot infection during the COVID-19
pandemic. J Foot Ankle Res 2020;13(1):37. https://doi.org/10.1186/s13047-020-00405-z
21. Mader JK. Personal experiences with coronavirus disease 2019 and diabetes: The time for telemedicine is now. J Diabetes Sci Technol 2020;14(4):752-3. https://doi.org/10.1177/1932296820930289
22. van Netten JJ, Clark D, Lazzarini PA, Janda M, Reed LF. The validity and reliability of remote diabetic foot ulcer
assessment using mobile phone images. Sci Rep 2017;7(1):9480. https://doi.org/10.1038/s41598-017-09828-4
23. Bolton L. Telemedicine improves chronic ulcer outcomes. Wounds 2019;31(4):114-6. PMID: 30924792
24. Moore Z, Butcher G, Corbett LQ, McGuiness W, Snyder RJ, van Acker K. Exploring the concept of a team
approach to wound care: Managing wounds as a team. J Wound Care 2014;23(Suppl 5b):S1-S38.
https://doi.org/10.12968/jowc.2014.23.Sup5b.S1
25. Fasterholdt I, Gerstrøm M, Rasmussen BSB, Yderstræde KB, Kidholm K, Pedersen KM. Cost-effectiveness of
telemonitoring of diabetic foot ulcer patients. Health Informatics J 2018;24(3):245-58. https://doi.org/10.1177/1460458216663026
26. Smith-Strøm H, Igland J, Østbye T, Tell GS, Hausken MF, Graue M, et al. The effect of telemedicine follow-up care on diabetes-related foot ulcers: A cluster-randomized controlled noninferiority trial. Diabetes Care 2018;41(1):96-103. https://doi.org/10.2337/dc17-1025
27. Yderstraede KB, Froekjaer J, Rasmussen BSB. Response to Comment on Rasmussen et al. A randomized controlled trial comparing telemedical and standard outpatient monitoring of diabetic foot ulcers. Diabetes Care 2015;38:1723-9. Diabetes Care 2016;39(1):e11. https://doi.org/10.2337/dci15-0018
28. Al-Sofiani ME, Alyusuf EY, Alharthi S, Alguwaihes AM, Al-Khalifah R, Alfadda A. Rapid implementation
of a diabetes telemedicine clinic during the coronavirus disease 2019 outbreak: Our protocol, experience, and
satisfaction reports in Saudi Arabia. J Diabetes Sci Technol 2020;1932296820947094. https://doi.org/10.1177/1932296820947094