<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>13</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Isabelle Dumont</style></author><author><style face="normal" font="default" size="100%">Kevin Deschamps</style></author><author><style face="normal" font="default" size="100%">Vera Eenkhoorn</style></author><author><style face="normal" font="default" size="100%">Patricia Félix</style></author><author><style face="normal" font="default" size="100%">Sabrina Houthoofd</style></author><author><style face="normal" font="default" size="100%">Patrick Lauwers</style></author><author><style face="normal" font="default" size="100%">Giovanni A. Matricali</style></author><author><style face="normal" font="default" size="100%">Caren Randon</style></author><author><style face="normal" font="default" size="100%">Eric Weber</style></author><author><style face="normal" font="default" size="100%">Kris Doggen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Declining offloading rates in Belgian Recognized Diabetic Foot Clinics (RDFC): results from an audit-feedback quality improvement initiative.</style></title><secondary-title><style face="normal" font="default" size="100%">14th annual meeting of the DFSG</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2017</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2017</style></date></pub-dates></dates><publisher><style face="normal" font="default" size="100%">Diabetic Foot Study Group</style></publisher><pub-location><style face="normal" font="default" size="100%">Porto, Portugal</style></pub-location><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Aim:&lt;/strong&gt; To evaluate how DFU (Diabetic Foot Ulcer) are offloaded in RDFC and the evolution over time. RDFC receive their results after each audit for benchmarking (IQED-Foot project).&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Method:&lt;/strong&gt; Comparison of offloading methods used in 2 audits (2011 and 2013/14). Audits characteristics are described in table 1. In each audit, RDFC registered the first 52 diabetic patients over a 1-year period with a “new” foot problem: DFU of Wagner grade 2 or more and/or active Charcot foot (table 2). Off-loading was categorized as follows: 1. &lt;strong&gt;knee-high device&lt;/strong&gt;, removable or not (TCC, Diabetic walkers...), 2 ankle-high &lt;strong&gt;shoe&lt;/strong&gt; or cast shoe, 3. &lt;strong&gt;other&lt;/strong&gt; off-loading techniques around the ulcer (felt, orthoses). 4. &lt;strong&gt;No off-loading&lt;/strong&gt;. In case of multiple means of off-loading, the most elaborate one was selected.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Results /Discussion:&lt;/strong&gt; Population characteristics in 2013/14 are described in table 3. For plantar ulcers, the overall offloading rate diminished significantly between 2011 and 2013/14, from 84.6% to 76.3% (P=0.01). A non-significant decrease was observed in the use of shoes (42.3 and 34.7% in 2011 and 2013/14 respectively, P&amp;gt;0.05), and no decrease in knee-high off-loading (14.8 and 14.7%) and other off-loading techniques (24.8 and 23.4%). For dorsal ulcers, &amp;nbsp;the overall off-loading rates were lower and the decline between 2011 and 2013/14 more pronounced (73.1 and 53.7%, P&amp;lt;0.001), affecting both ankle-high off-loading (31.1 and 21.9%, P=0.02) and other off-loading techniques (30.4 and 19.9%, P=0.02), but not knee-high off-loading (7.0 and 8.1%).&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Periodical audits in Belgian Recognized Diabetic Foot Clinics have shown a decline in offloading rates. The percentage of patients without any offloading device is increasing. Audit and feedback including non-public anonymous benchmarking has not been able to prevent this decline. Knowing that offloading is the cornerstone of DFU treatment these results are worrying, although overall off-loading rates were comparable to those reported in Eurodiale. Efforts are needed to understand and tackle the barriers towards a correct application of gold standard offloading techniques.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">Diabetic Foot Study Group</style></issue></record></records></xml>