{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:35:45Z","timestamp":1790354145338,"version":"4.1.0"},"reference-count":11,"publisher":"Mark Allen Group","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2018,3,2]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. <\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p> A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU. The second part of the questionnaire collected data on recently managed DFU cases. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> There were 600 questionnaires collected in the first part of the study (150 per country), and 1188 patient cases of DFU management were included in the second part. Up to 95% of patients had type 2 diabetes. Patients' complaints led to diagnosis, on average, 60% of the time, and the diagnosis was an incidental finding during a consultation 13\u201328% of the time. On average, only 40% of GPs completely agreed that they have clearly identified DFU clinical practitioners working in a hospital facility. In 55\u201366% of cases, the duration of DFU was unknown or DFU diagnosis was delayed more than three weeks from the onset of the wound. On average, 48% of patients were referred after an unknown duration or more than one month from the onset of DFU. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Despite differences in health-care structures across Europe, delays in referral to specialist foot care teams seems to be a common theme. There is an ongoing need to educate GPs, nurses and patients to be more aware of the risk of DFU, and the need for prompt referral to specialist diabetic foot teams. <\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2018.27.3.186","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T15:21:41Z","timestamp":1520349701000},"page":"186-192","source":"Crossref","is-referenced-by-count":67,"title":["Delayed referral of patients with diabetic foot ulcers across Europe: patterns between primary care and specialised units"],"prefix":"10.12968","volume":"27","author":[{"given":"Chris","family":"Manu","sequence":"first","affiliation":[{"name":"King's College Hospital, Denmark Hill, SE5 9RS London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Lacopi","sequence":"additional","affiliation":[{"name":"University of Pisa, Ospedale di Cisanello, via Paradisa 2, 56126 Pisa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Bouillet","sequence":"additional","affiliation":[{"name":"CHU de Dijon, 2 boulevard Mar\u00e9chal de Lattre de Tassigny, 21000 DIJON"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Vouillarmet","sequence":"additional","affiliation":[{"name":"JCHU Lyon Sud, Pavillon M\u00e9dical, 165 chemin du Grand Revoyet 69495 Pierre B\u00e9nite"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raju","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"King's College Hospital, Denmark Hill, SE5 9RS London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claas","family":"L\u00fcdemann","sequence":"additional","affiliation":[{"name":"Franziskus Krankenhaus Berlin, Budapester Strasse, 15-19, 10787 BERLIN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Garcia-Klepzig","sequence":"additional","affiliation":[{"name":"Hospital Clinico San Carlos De Madrid, Calle Profesor Martin Lagos, 28040 Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Meloni","sequence":"additional","affiliation":[{"name":"University of Roma Tor Vergata, Viale Oxford 81, 00133 Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor Rodriguez-Saenz","family":"De Buruaga","sequence":"additional","affiliation":[{"name":"Donostia Hospital Universitario San Sebastian, Calle Prim N\u00b0 14 - 20006 San Sebastian"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pedro","family":"S\u00e1nchez-R\u00edos","sequence":"additional","affiliation":[{"name":"Hospital Universitario Fundacion Alcorcon, Calle Budapest, 1, 28922 Alcorc\u00f3n, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Edmonds","sequence":"additional","affiliation":[{"name":"King's College Hospital, Denmark Hill, SE5 9RS London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Apelqvist","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Hospital of Malm\u00f6, S-205 02 Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"L\u00e1zaro-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Universidad Complutense de Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristien","family":"Van Acker","sequence":"additional","affiliation":[{"name":"Familie Ziekenhuis. 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