Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review
Abstract Background Acute Charcot Neuroarthropathy (CN) is a destructive condition that is characterised by acute fractures, dislocations and joint destruction in the weight‐bearing foot. The acute phase is often misdiagnosed and can rapidly lead to devastating health outcomes. Early diagnosis and m...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-021-00469-5 |
| _version_ | 1797321349920718848 |
|---|---|
| author | D. Diacogiorgis B. M. Perrin M. I. C. Kingsley |
| author_facet | D. Diacogiorgis B. M. Perrin M. I. C. Kingsley |
| author_sort | D. Diacogiorgis |
| collection | DOAJ |
| description | Abstract Background Acute Charcot Neuroarthropathy (CN) is a destructive condition that is characterised by acute fractures, dislocations and joint destruction in the weight‐bearing foot. The acute phase is often misdiagnosed and can rapidly lead to devastating health outcomes. Early diagnosis and management of CN is imperative to attenuate progression of this condition. Consequently, timely evidence‐based assessment, diagnosis and management of acute CN is imperative. Objective To identify the factors that impact the delivery of evidence‐based care in assessment, diagnosis and management of people with acute CN. Method Systematic searches were conducted in four databases to identify studies in English that included factors that impact the delivery of evidence‐based care in the assessment, diagnosis and management of people with acute CN. Articles and consensus/guideline documents were assessed for inclusion by the researchers and disagreements were resolved through consensus. Additionally backward citation searching was used to source other potentially relevant documents. Information relevant to the research question was extracted and thematic analyses were performed using qualitative synthesis. Results Thirty‐two articles and four additional consensus/guideline documents were included for data extraction and analyses. Information related to the research question was of expert opinion using the National Health and Medical Research Council (NHMRC) Levels of Evidence guidelines. Themes explaining practices that deviated from evidence‐based care in assessment, diagnosis and management of acute CN centred around patient, health professional and health organisation/environmental. Delay to diagnosis is particularly influenced by the patient's knowledge of when to seek help, practitioner knowledge in knowing how to recognise and refer for appropriate immediate care, confusion in imaging and offloading and geographical and local health service resources to appropriately manage the condition. Conclusion Individual and health professional awareness and geographical barriers are key challenges to the effective delivery of evidence‐based assessment, diagnosis and management of people with acute CN. Acute CN represents a medical emergency warranting the need for expedited assessment, diagnosis and management by appropriately trained health professionals in the appropriate. |
| first_indexed | 2024-03-08T04:56:21Z |
| format | Article |
| id | doaj.art-490d61c261b94f33a700d56641b33d33 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:56:21Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-490d61c261b94f33a700d56641b33d332024-02-07T15:10:48ZengWileyJournal of Foot and Ankle Research1757-11462021-01-01141n/an/a10.1186/s13047-021-00469-5Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic reviewD. Diacogiorgis0B. M. Perrin1M. I. C. Kingsley2Department of Podiatry and Allied Health AssistantsBallarat Health ServicesBallaratAustraliaLa Trobe Rural Health SchoolCollege of ScienceHealth and EngineeringLa Trobe UniversityBendigoAustraliaHolsworth Research InitiativeLa Trobe Rural Health SchoolCollege of ScienceHealth and EngineeringLa Trobe UniversityBendigoAustraliaAbstract Background Acute Charcot Neuroarthropathy (CN) is a destructive condition that is characterised by acute fractures, dislocations and joint destruction in the weight‐bearing foot. The acute phase is often misdiagnosed and can rapidly lead to devastating health outcomes. Early diagnosis and management of CN is imperative to attenuate progression of this condition. Consequently, timely evidence‐based assessment, diagnosis and management of acute CN is imperative. Objective To identify the factors that impact the delivery of evidence‐based care in assessment, diagnosis and management of people with acute CN. Method Systematic searches were conducted in four databases to identify studies in English that included factors that impact the delivery of evidence‐based care in the assessment, diagnosis and management of people with acute CN. Articles and consensus/guideline documents were assessed for inclusion by the researchers and disagreements were resolved through consensus. Additionally backward citation searching was used to source other potentially relevant documents. Information relevant to the research question was extracted and thematic analyses were performed using qualitative synthesis. Results Thirty‐two articles and four additional consensus/guideline documents were included for data extraction and analyses. Information related to the research question was of expert opinion using the National Health and Medical Research Council (NHMRC) Levels of Evidence guidelines. Themes explaining practices that deviated from evidence‐based care in assessment, diagnosis and management of acute CN centred around patient, health professional and health organisation/environmental. Delay to diagnosis is particularly influenced by the patient's knowledge of when to seek help, practitioner knowledge in knowing how to recognise and refer for appropriate immediate care, confusion in imaging and offloading and geographical and local health service resources to appropriately manage the condition. Conclusion Individual and health professional awareness and geographical barriers are key challenges to the effective delivery of evidence‐based assessment, diagnosis and management of people with acute CN. Acute CN represents a medical emergency warranting the need for expedited assessment, diagnosis and management by appropriately trained health professionals in the appropriate.https://doi.org/10.1186/s13047-021-00469-5DiabetesCharcotFootPeripheral neuropathyNeuroarthropathy |
| spellingShingle | D. Diacogiorgis B. M. Perrin M. I. C. Kingsley Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review Journal of Foot and Ankle Research Diabetes Charcot Foot Peripheral neuropathy Neuroarthropathy |
| title | Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review |
| title_full | Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review |
| title_fullStr | Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review |
| title_full_unstemmed | Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review |
| title_short | Factors impacting the evidence‐based assessment, diagnosis and management of Acute Charcot Neuroarthropathy: a systematic review |
| title_sort | factors impacting the evidence based assessment diagnosis and management of acute charcot neuroarthropathy a systematic review |
| topic | Diabetes Charcot Foot Peripheral neuropathy Neuroarthropathy |
| url | https://doi.org/10.1186/s13047-021-00469-5 |
| work_keys_str_mv | AT ddiacogiorgis factorsimpactingtheevidencebasedassessmentdiagnosisandmanagementofacutecharcotneuroarthropathyasystematicreview AT bmperrin factorsimpactingtheevidencebasedassessmentdiagnosisandmanagementofacutecharcotneuroarthropathyasystematicreview AT mickingsley factorsimpactingtheevidencebasedassessmentdiagnosisandmanagementofacutecharcotneuroarthropathyasystematicreview |