Integrated Care Model for Diabetic Foot Ulcers

JL
Overseen ByJamie LaMantia
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Wisconsin, Madison
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to reduce major amputations (removal of a limb) in people with diabetic foot ulcers, focusing on those in rural areas. It tests a new integrated care model, a coordinated healthcare approach, which has already reduced amputations in cities by about 40%. Participants include patients with type 1 or type 2 diabetes who develop foot ulcers while receiving care at specific rural clinics. The trial compares patients receiving the new care approach to those who received standard care before the trial. As an unphased trial, it offers patients the chance to contribute to innovative care solutions that could significantly improve outcomes for those with diabetic foot ulcers.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

What prior data suggests that this integrated care model is safe for patients with diabetic foot ulcers?

Research has shown that the integrated care model for treating diabetic foot ulcers is generally well-received and safe for patients. Past studies have demonstrated improvements in ulcer management with this approach. For instance, one study involving 2,798 patients showed promising results in wound care.

No specific safety issues have been reported, and this model has effectively reduced major amputations by about 40% in cities. This suggests safety, as better management typically leads to fewer complications.

It is important to note that the current trial is not in a specific phase, so there may be limited data on long-term safety. However, the model has been adapted from successful city programs, providing some confidence in its safety for patients in rural areas.12345

Why are researchers excited about this trial?

Researchers are excited about the Integrated Care Model for diabetic foot ulcers because it offers a more comprehensive approach compared to traditional treatments, which often focus on isolated aspects of care like wound cleaning, dressing, and antibiotics. This model integrates various aspects of patient care, including coordination between multiple healthcare providers and personalized management strategies, which can lead to better overall outcomes. By fostering collaboration among healthcare providers, the integrated model aims to address the underlying causes of ulcers more effectively and reduce healing times, potentially leading to fewer amputations and improved quality of life for patients.

What evidence suggests that this integrated care model is effective for diabetic foot ulcers?

Research has shown that integrated care models, like the one tested in this trial, have reduced major amputations in cities by about 40%. One study examined 2,798 patients with diabetic foot ulcers (DFUs) and found that personalized, ongoing care improved management and accelerated wound healing. Personalized care models clearly benefit DFU healing, simplifying the management of these challenging wounds. Another study found that with traditional care, only 45.5% of DFU patients healed within a year, underscoring the need for improved methods like integrated care. These findings suggest that integrated care models can effectively treat diabetic foot ulcers, especially in rural areas where the risk of amputation is higher. Participants in this trial will receive care through the integrated care model, while historical controls will reflect outcomes from standard care before the intervention.26789

Who Is on the Research Team?

MB

Meghan B Brennan, MD

Principal Investigator

University of Wisconsin, Madison

Are You a Good Fit for This Trial?

This trial is for healthcare workers and patients in rural clinics. Workers must consent, be employed at a participating clinic, available throughout the study, and follow procedures. Patients need to consent, be 18+, have type 1 or type 2 diabetes, develop a foot ulcer during enrollment, and comply with the study. Exclusions include insurance issues and unsuitability for aggressive treatment.

Inclusion Criteria

I have diabetes and am treated at a rural clinic.
Healthcare worker inclusion criteria: Employed at a participating clinic
I developed a diabetic foot ulcer while enrolled in the study.
See 6 more

Exclusion Criteria

Patient exclusion criteria: Insurance does not cover referral to the University of Wisconsin's specialty clinics
Healthcare worker exclusion criteria: Insufficient overlap in work schedules between rural providers and scheduler based on clinic manager determination
Patient exclusion criteria: Not suitable for study participation due to other reasons at the discretion of the investigators
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive integrated care for diabetic foot ulcers, focusing on reducing major amputations

3 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

up to 2 years and 3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Integrated Care Model
Trial Overview The trial tests an integrated care model adapted for rural settings to reduce major amputations caused by diabetic foot ulcers. It aims to gather data on recruitment strategies and provide preliminary evidence of efficacy that could lead to a larger statewide trial.
How Is the Trial Designed?
2Treatment groups
Active Control
Group I: Historical controlsActive Control1 Intervention
Group II: Integrated careActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Wisconsin, Madison

Lead Sponsor

Trials
1,249
Recruited
3,255,000+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials
2,513
Recruited
4,366,000+

Published Research Related to This Trial

In a study of 299 participants with clinically infected diabetic foot ulcers, only 45.5% achieved healing within 12 months, highlighting the generally poor clinical outcomes for these patients.
Factors negatively impacting healing included longer ulcer duration (≥2 months) and higher PEDIS perfusion grades (≥2), while having a single ulcer was associated with better healing outcomes.
Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study.Ndosi, M., Wright-Hughes, A., Brown, S., et al.[2022]

Citations

Outcome evaluation and cost-effectiveness analysis for an ...We conducted an observational study to analyze 2798 patients with diabetic foot ulcers (DFUs) enrolled in the program between June 2020 and June ...
Effectiveness of personalized continuous care in wound ...Overall, personalized continuous care demonstrates significant advantages in the management of diabetic foot ulcer (DFU) patients, as it promotes wound healing, ...
NCT03827902 | Diabetic Foot Ulcer and Wound InfectionThe effectiveness of the technologically facilitated integrated model of care will be evaluated compared to the usual care using metrics for diabetic foot ...
Integrated Care Model for Diabetic Foot UlcersIn a study of 299 participants with clinically infected diabetic foot ulcers, only 45.5% achieved healing within 12 months, highlighting the generally poor ...
Advancements and best practices in diabetic foot CareThis review aims to consolidate recent advancements and best practices in managing diabetic foot conditions, encompassing foot ulcers, neuropathy, vascular ...
Exploring diabetic foot screening programs with integrated ...This review aims to analyze foot screening programs or initiatives for individuals at risk of DFUs and LEAs, define their key components and ...
Emerging technologies for the management of diabetic foot ...The presence of diabetic foot ulcers significantly increases mortality rates among patients with diabetes, surpassing that of diabetes alone (4) ...
Impact on management performance outcomes of ...Implementing ICBs can help to improve wound management outcomes and reduce labor costs compared with non-standardized care without an ICB.
Outcome evaluation and cost-effectiveness analysis for an ...We conducted an observational study to analyze 2798 patients with diabetic foot ulcers (DFUs) enrolled in the program between June 2020 and June ...
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