J Foot Ankle Res. 2015 Dec 09;8:71. doi: 10.1186/s13047-015-0130-5. eCollection 2015.

Vascular assessment techniques of podiatrists in Australia and New Zealand: a web-based survey.

Journal of foot and ankle research

Peta Ellen Tehan, Vivienne Helaine Chuter

PMID: 26664522 PMCID: PMC4673851 DOI: 10.1186/s13047-015-0130-5

Abstract

BACKGROUND: Podiatrists play a central role in conducting non-invasive vascular assessment in the lower extremity. This involves screening for signs and symptoms of peripheral arterial disease (PAD) and ongoing monitoring of the condition. Podiatric vascular assessment practices in Australia and New Zealand are currently unclear. Determining the clinical habits of Podiatrists is essential in identifying if there is a need for further education or support in performing accurate vascular assessments.

METHODS: A web-based, secure, anonymous questionnaire was conducted of registered Podiatrists in Australia and New Zealand between 1 April and 31 July 2013. The questions examined clinician's regular practices in vascular assessment, clinical indicators to perform and barriers in completing vascular assessment. Nominal logistic regression was performed to further examine years of experience and practice setting on clinical indicators to perform vascular assessment and types of assessment performed.

RESULTS: Four hundred forty-seven podiatrists participated in the survey. Clinical indicators for vascular assessment, along with barriers and available equipment were examined and the results varied depending on the podiatrists' geographical location, practice setting, and experience. Palpation of pedal pulses was the most frequently reported assessment (97 %) along with Doppler assessment (74 %). Pressure measurement was the least frequently reported vascular assessment method, with only 34 % undertaking ankle-brachial indices and 19 % completing toe-brachial indices. Public podiatrists reported more varied and complete vascular assessment compared to those in private practice. Lack of time was identified as the most frequently reported barrier (66 %) in performing vascular assessment, followed by lack of equipment (28 %). In New Zealand podiatrists, lack of equipment was much more of an issue than in Australian podiatrists.

CONCLUSION: Large variations exist in vascular assessment methods amongst Australian and New Zealand podiatrists. Some assessments being undertaken are potentially inadequate for accurate screening for PAD. There is a need for continuing education in vascular assessment to address the deficiencies in technique reported by some Podiatrists. A podiatry-relevant summary of broad international guidelines for PAD screening may be of use to improve utilisation and accuracy of screening methods to improve patient management.

Keywords: Clinical practice; Non-invasive vascular assessment; Podiatrist; Survey

References

1. J Foot Ankle Res. 2008 Aug 19;1(1):8 - PubMed
2. J Foot Ankle Res. 2012 Jun 07;5:13 - PubMed
3. J Wound Ostomy Continence Nurs. 2006 Jan-Feb;33(1):30-41 - PubMed
4. BMC Fam Pract. 2014 Apr 17;15:69 - PubMed
5. Circ J. 2008 Apr;72 (4):605-10 - PubMed
6. Cochrane Database Syst Rev. 2014 Apr 07;(4):CD010835 - PubMed
7. Cleve Clin J Med. 2006 Jul;73(7):621-6, 628, 632-4, passim - PubMed
8. Vasc Med. 2004 Nov;9(4):253-60 - PubMed
9. Eur J Vasc Endovasc Surg. 2005 May;29(5):443-51 - PubMed
10. J Gen Intern Med. 1999 Jul;14(7):418-24 - PubMed
11. Diabetes Care. 2005 Sep;28(9):2206-10 - PubMed
12. J Foot Ankle Res. 2010 Dec 22;3:31 - PubMed
13. J Foot Ankle Res. 2012 Jul 30;5(1):19 - PubMed
14. Vascular. 2015 Dec;23 (6):622-9 - PubMed
15. J Vasc Interv Radiol. 2006 Sep;17(9):1383-97; quiz 1398 - PubMed
16. J Am Coll Cardiol. 2011 Nov 1;58(19):2020-45 - PubMed
17. Vasc Med. 2007 May;12 (2):105-12 - PubMed

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• Journal Article