Exploring Australian High‐Risk Foot Podiatrists' Understanding of Recurrent and Contralateral Charcot Neuroarthropathy in Individuals With Diabetes Mellitus: A Qualitative Study

TL;DR

This study explores how Australian podiatrists understand and manage recurring and opposite foot complications in diabetic patients.

Contribution

The study identifies perceived risk factors and preventive interventions for recurrent and contralateral Charcot neuroarthropathy from a podiatrist perspective.

Findings

Podiatrists identified risk factors like reduced adherence and lack of knowledge for recurrent Charcot neuroarthropathy.

Preventive interventions were reported but not consistently applied due to barriers like financial and personal endurance.

There is a lack of standardized care for preventing recurrent and contralateral Charcot neuroarthropathy.

Abstract

Charcot neuroarthropathy (CN) can result in severe destruction of the foot and the ankle. Additional episodes of acute CN in the same or contralateral foot cause additional burden. This study aimed to explore Australian high‐risk foot podiatrists' understanding of recurrent and contralateral CN in individuals with diabetes.

Semi‐structured online interviews were conducted. Interviews were audio‐recorded and transcribed. Thematic content analysis was used.

Five themes were identified in relation to recurrent and contralateral CN—two were related to potential risk factors: patients and systems and addressing clinical complexity, two were related to preventive interventions: protection as prevention and knowledge and surveillance and one was related to barriers to implementing preventive interventions: financial and personal endurance. The most reported risk factors were reduced adherence to management and lack of knowledge. Many preventive interventions were reported, but there was a lack of consensus on standardised care, and due to significant barriers, these interventions were not frequently used.

This study found that participants perceived a range of potential risk factors for recurrent and contralateral CN. They also reported a variety of preventive interventions; however, due to associated barriers, these were not frequently applied. Further rigorous research is needed to develop evidence‐based guidelines.