$1.3M Grant for Diabetes Footcare Rural Outreach Study

The project, Queensland Diabetes Footcare Hubs (Q DFootHubs), has received $1,363,466.75 from the National Health and Medical Research Council (NHMRC) under its Partnership Projects program.

The project's co-lead, QUT Associate Professor Peter Lazzarini, from the School of Public Health and Social Work and The Prince Charles Hospital, said the project's overarching aim was to evaluate the impact in rural populations of Diabetes Footcare Hubs or DFootHubs .

"DFootHubs are co-designed, evidence-based, hub-spoke, telehealth models of care for people with diabetes foot disease (DFD)," Professor Lazzarini said.

"Diabetes foot disease is now the thirteenth largest cause of the global disease burden and is estimated to cause a global burden as large as the breast cancer and dementia burdens combined.

"More than 380,000 Australians have DFD resulting in more than 27,600 hospitalisations, 4,500 amputations, and $1.6 billion in costs each year in Australia."

Professor Lazzarini said the project brought together world-leading clinicians, policy makers and researchers with strong track records of integrating research evidence into care delivery.

"As the leading Australian research team for DFD, we are partnering with Clinical Excellence Queensland, four Hospital & Health Services, and three national diabetes bodies to help improve access, quality and outcomes of footcare for rural people with DFD," he said.

"Recent systematic reviews of studies in the area show evidence-based footcare can halve hospitalisation and amputation rates in people with diabetes foot disease.

"This evidence-based footcare typically includes offloading treatments to reduce any high pressure areas, wound dressings for ulcers, antibiotics for infections and revascularisation procedures for any poor circulation by teams of doctors, surgeons, nurses and allied health professionals.

"However, studies also show very high rural hospitalisation and amputation rates due to poor access to evidence-based footcare. Our project will address this by evaluating the implementation of these novel DFootHubs across two large, diverse regions of Queensland: Northern and Central Queensland.

"Each DFootHub will include three core components: a navigator or coordinator, an inter-disciplinary footcare team, and a community digital platform of pathways and telehealth to connect rural people with DFD to expert footcare teams in major city hospitals.

"As part of this four-year project we will robustly evaluate these DFootHub models using a hybrid effectiveness-implementation study design.

"Our evaluation will be guided by best practice implementation science frameworks to determine their impact on the reach, access, effectiveness, adoption, implementation, sustainability, and the potential for scalability of these DFootHubs with our national partners and national expert team."

(Image from left: Professor Steven McPhail, Associate Professor Peter Lazzarini, Associate Professor Christina Parker. Bottom left: Associate Professor Zephanie Tyack, Associate Professor Susanna Cramb).

The study's chief investigator team includes Associate Professor Lazzarini (co-lead), Professor Steven McPhail, Associate Professor Zephanie Tyack, Associate Professor Susanna Cramb, all from the QUT School of Public Health and Social Work, Associate Professor Christina Parker from the QUT School of Nursing; Professors Jonathan Golledge (co-lead) and Sarah Larkins from James Cook University; Professor James Charles from Griffith University; and Professor Jaap van Netten from the University of Amsterdam.

The study also has a large national expert associate investigator team to particularly advise on the scalability of the project, including Dr Bernd Ploderer from QUT; Professor Vivienne Chuter from Western Sydney University; Associate Professor Byron Perrin from La Trobe University; Dr Laurens Manning and Dr Emma Hamilton from the University of Western Australia; Professor Robert Fitridge from the University of Adelaide; Professor Anthony Russell from Monash University; Professor Stephen Twigg from the University of Sydney; and Ms Jane Cheney from Diabetes Victoria.

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