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Comparing Foot Evaluation In Hospitalized Diabetic Patients between Surgeons, Orthopedicians and Physicians Through Amit Jain’s Triple Assessment

DOI : https://doi.org/10.36349/EASMS.2020.v03i05.001
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Aim – To assess the compliance of healthcare professionals that include physicians, surgeons and orthopedicians in screening of foot in diabetes and analysing it through Amit Jain’s triple assessment. Methods and materials –A prospective comparative study was conducted at Raja Rajeswari Medical College, Bengaluru, India, which is a teaching hospital. All the new diabetic patients who were admitted in medicine ward by physicians, surgical ward by general surgeons and orthopaedic ward by orthopaedic surgeon were studied by us and they were divided in 3 groups. Statistical analysis was done using SPSS 22.0 and R environment ver.3.2.2. Results – Each group had 20 patients. 80% of patients had diabetes of less than 10 years and there was no difference in both groups. Chronic kidney disease was significantly common in patients in group A (P- 0.039*). Foot screening was done by physicians in 15%, 5% by surgeons and screening of foot was not done by orthopedicians. 3.3% of patients were detected to have foot ulcer during screening. The triple assessment of foot consisting of looking for ulcer/infection, feeling foot pulses and testing for sensation was poor on both feet and there was no difference among all 3 groups. Significant association was noted between detection of ulcer and foot screening (P-0.003**). Conclusion – Screening of foot was extremely low among all the 3 specialists. Amit Jain’s triple assessment being the simplest and fastest screening tool, can be done with ease requiring minimum instruments. It is not just the patients who need to be educated, but even health care professionals requires to be educated on need for screening of foot if reduction in amputation is needed and we believe that this linear foot test should be a minimum evaluation tool for every healthcare professional as it addresses the triad of diabetic foot efficiently and effectively.

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Dr. Afroza Begum

Lecturer, Dept. of Pharmacology and Therapeutics, Shaheed Monsur Ali Medical College & Hospital, Uttara, Dhaka-1230, Bangladesh

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