Impact of patient-education on health related quality of life of diabetic foot ulcer patients: A randomized study

Background: Diabetic foot is the most serious and disabling long term complication of diabetes, adversely affecting the health related quality of life (HRQoL). Objectives: To evaluates the impact of patient-education (PE) on HRQoL of diabetic foot ulcer (DFU) patients. Methods: This randomized controlled study on the effect of PE on improvement of HRQoL, conducted in Kasturba Hospital, Manipal, India consisted of 135 DFU patients with 65 subjects in the control group (CG) and 70 subjects in the intervention group (IG). RAND-36 questionnaire was employed for evaluating HRQoL scores of DFU patients in both groups at baseline and after six months of PE. Results: Subjects in the both IG and CG reported poor HRQoL scores, on all the eight subscales at baseline. After six months of PE, HRQoL improved substantially in IG with respect to CG and IG at baseline (p < 0.05). Likewise, in both CG and IG, the physical component summary scale (PCS) scores (24.1 ± 6.6 vs 25.6 ± 7.3) and the mental component summary scale (MCS) scores (27.3 ± 5.4 vs 28.8 ± 7.1) were similar and poor before PE. However, six months post PE, in IG, the Both PCS and MCS scores increased dramatically from 25.6 ± 7.3 to 42.9 ± 9.7 and 28.8 ± 7.1 to 48.8 ± 8.4 (p < 0.05) respectively. Conclusion: The remarkable improvement in the HRQoL in IG at six months follow-up suggests that PE significantly improves HRQoL in DFU patients. Overworked physicians and paucity of trained doctors in resource-poor settings obligate task-sharing with non-physician healthcare providers.