{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:44:42Z","timestamp":1791499482221,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,15]],"date-time":"2017-12-15T00:00:00Z","timestamp":1513296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2018,2]]},"abstract":"ABSTRACT<\/jats:title>The aim of this study was to estimate the patterns of care and annual levels of health care resource use attributable to managing diabetic foot ulcers (DFUs<\/jats:styled-content>) in clinical practice by the UK<\/jats:styled-content>'s National Health Service (NHS<\/jats:styled-content>), and the associated costs of patient management.<\/jats:p>This was a retrospective cohort analysis of the records of 130 patients with a newly diagnosed DFU<\/jats:styled-content> in The Health Improvement Network (THIN<\/jats:styled-content>) database. Patients' characteristics, wound\u2010related health outcomes and health care resource use were quantified, and the total NHS<\/jats:styled-content> cost of patient management was estimated at 2015\u20132016 prices.<\/jats:p>Patients were predominantly managed in the community by nurses, with minimal clinical involvement of specialist physicians. 5% of patients saw a podiatrist, and 5% received a pressure\u2010offloading device. Additionally, 17% of patients had at least one amputation within the first 12 months from initial presentation of their DFU. 14% of DFUs<\/jats:styled-content> were documented as being clinically infected at initial presentation, although an additional 31% of patients were prescribed an antimicrobial dressing at the time of presentation. Of all the DFUs<\/jats:styled-content>, 35% healed within 12 months, and the mean time to healing was 4\u00b74 months. Over the study period, 48% of all patients received at least one prescription for a compression system, but significantly more patients healed if they never received compression (67% versus 16%; P<\/jats:italic> < 0\u00b7001). The mean NHS<\/jats:styled-content> cost of wound care over 12 months was an estimated \u00a37800 per DFU<\/jats:styled-content> (of which 13% was attributable to amputations), ranging from \u00a32140 to \u00a38800 per healed and unhealed DFU,<\/jats:styled-content> respectively, and \u00a316 900 per amputated wound.<\/jats:p>Consolidated medical records from a primary care held database provided \u2018real\u2010world evidence\u2019 highlighting the consequences of inefficient and inadequate management of DFUs<\/jats:styled-content> in clinical practice in the UK<\/jats:styled-content>. Clinical and economic benefits to both patients and the NHS<\/jats:styled-content> could accrue from strategies that focus on (i) wound prevention, (ii) improving wound\u2010healing rates and (iii) reducing infection and amputation rates.<\/jats:p>","DOI":"10.1111\/iwj.12816","type":"journal-article","created":{"date-parts":[[2017,12,16]],"date-time":"2017-12-16T10:44:39Z","timestamp":1513421079000},"page":"43-52","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":128,"title":["Diabetic foot ulcer management in clinical practice in the UK: costs and outcomes"],"prefix":"10.1111","volume":"15","author":[{"given":"Julian F","family":"Guest","sequence":"first","affiliation":[{"name":"Catalyst Health Economics Consultants Rickmansworth UK"},{"name":"Faculty of Life Sciences and Medicine King's College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham W","family":"Fuller","sequence":"additional","affiliation":[{"name":"Catalyst Health Economics Consultants Rickmansworth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vowden","sequence":"additional","affiliation":[{"name":"Bradford Teaching Hospitals NHS Foundation Trust and University of Bradford Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.5.1435"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp032966"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_2_7_5_1","first-page":"1655","article-title":"Diabetic foot ulcers: pathogenesis and management","volume":"66","author":"Frykberg RG","year":"2002","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2004.01375.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaad.2013.07.048","article-title":"Diabetic foot ulcers: Part II. 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