Telemedicine and diabetic foot ulcer outcomes. A meta-analysis of controlled trials

Foot (Edinb). 2022 Mar:50:101872. doi: 10.1016/j.foot.2021.101872. Epub 2021 Oct 25.

Abstract

Telemedicine (TM) has been advanced as an effective approach to wound care management. In this era of COVID-19 pandemic, it is paramount to assess the evidence behind the use of TM in treating diabetic foot ulcers (DFU). This meta-analysis aims at evaluating the efficacy of TM versus face-to-face attendance in managing DFU. In total, four controlled studies were included in the meta-analysis comprising 3 randomized trials. The total pooled sample comprised 816 patients (816 ulcers): 337 in TM group and 479 in the control group. The results were as follows: (a) healing rate OR was 1.35, in favor of TM (p = 0.4), (b) time to heal with means of 73 ± 24.1 days and 83.5 ± 28.4 days, for the TM and control group, respectively (p = 0.35), c) the amputation rate OR was 0.48 (p = 0.007) in favor of the TM group, d) the mortality rate OR was 1.66 (p = 0.2), and e) a trend for lesser cost than face-to-face group (p = 0.4). While future research using large-sampled controlled studies is warranted, the present meta-analysis demonstrated that treating DFU via TM could be at least as effective as to face-to-face attendance. In times where clinic visits are reduced or not possible such as during this COVID-19 pandemic and the likely-to-happen future outbreaks, TM could be a valuable alternative.

Keywords: Diabetic foot ulcers; Telemedicine; eHealth.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • COVID-19* / epidemiology
  • Diabetes Mellitus*
  • Diabetic Foot* / therapy
  • Humans
  • Pandemics
  • SARS-CoV-2
  • Telemedicine*