Email and telephone consultations could help diabetic foot ulcer patients as much as in-person visits

Adults with diabetic foot ulcers could benefit just as much from a telephone or email consultation as from an in-person meeting, according to new research published in Diabetes Care.
The Danish study, which was conducted by researchers at Odense University Hospital in Denmark, used data from 401 adults to assess the potential effectiveness of email and telephone consultations for people with diabetic foot ulcers.
193 participants were given “telemedicine monitoring,” which involved two consultations by phone or email. The participants also uploaded images of their ulcer and were given detailed written assessments, as well as a single in-person visit to their doctor. 181 patients only received the in-person visit. The control group was treated normally, without the intervention of telemedical consultation.
There was no real difference in terms of ulcer healing between those given phone and email consultation and those seen in person. 72 per cent of the first group saw their ulcers heal compared to 73 per cent of the control group, a difference which is hardly significant.
That said, there was a significant difference in mortality rates between the two groups. Eight people died from the first group, which received telemedical consultatio, compared to only one person in the control group. Every patient who died had chronic heart disease, four of them had chronic kidney disease, and one had prostate cancer.
“The significance difference in mortality between the telemedical and standard outpatients monitoring groups could not be explained by the selected variables,” the researchers wrote. “Further investigation of comorbidities and other possible reasons has been undertaken.”
“The findings of no significant difference regarding amputation and healing seem promising; however, for telemedical monitoring, a higher mortality throws into question the role of telemedicine in monitoring diabetic foot ulcers.”
The researchers hope that further research will investigate the effects of telemedicine on mortality, and identify which particular health conditions could be treated with telemedicine. If successful, the findings could ease the burden on healthcare systems in terms of waiting times to see doctors.

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