APMA News - March/April 2020 - 18

More Evidence Suggests DPMs Play
Key Role in Diabetes Amputation Reduction
A new research study led by 2018-19
APMA/TDI Public Health Fellow Rachel
Albright, DPM, MPH, demonstrates that
multidisciplinary care teams can reduce amputation rates in diabetic patients by more
than 50 percent. "Effectiveness of multidisciplinary care teams in reducing major
amputation rate in adults with diabetes: A
systematic review & meta-analysis" is published in Diabetes Research and Clinical
Practice1.
While the study does not specifically examine the role of podiatry, previous studies
(i.e., Thomson Reuters2 and Duke3) showed
the value podiatrists add to a multidisciplinary team. APMA recently spoke with Dr.
Albright to discuss her findings.

mending them, but at the same time,
there were articles discussing how expensive it can be to implement and sustain
these teams. I realized there were really
no articles that helped health-care systems thinking of implementing a team
estimate how much of an impact a team
could have on its outcomes. I felt like this
was a major void in the literature that we
could fill.

APMA News:
How do you suggest your findings be put
into use in clinical practice? In particular,
how should they drive change for or recognition of podiatry's role in diabetes care?
Dr. Albright:
It seems well understood that multidisciplinary
teams are important when
Rachel Albright, DPM
caring for complex diabetic foot problems, but there are still many teams that
APMA News:
have
excluded
podiatry,
despite our ability to lower costs and
Tell us more about the findings of your research.
provide
high-quality
care.
Although my paper doesn't directDr. Albright:
ly speak to the specific role podiatry can play, there are sevWe found that people with diabetes who were exposed to a
eral articles in print to speak to podiatry's worth on these
multidisciplinary care team were 39-56-percent less likely to
teams (Thomson Reuters, Duke). It's my hope that when a
undergo amputation than patients who did not have care from
health-care system is considering implementing a team, it would
a team. We also found that one of the most common team memconsider podiatry an essential component.
bers utilized was a podiatrist! Although we can't prove through
our data alone that podiatry had a specific impact on amputation rates, there is already published literature highlighting better outcomes when podiatrists are involved in diabetic foot care,
so it would make sense to think we are one of the most valuable
team members.
APMA News:
What prompted you to make this your topic of investigation?
Dr. Albright:
This was work I started in my fellowship. I was looking for a
research topic that was of interest to several specialties. When
I was reading up on multidisciplinary groups, it seemed clear
that all the major organizations (e.g., the Infectious Diseases
Society of America, the International Working Group on the Diabetic Foot, the Society for Vascular Surgery) were recom-

1 www.diabetesresearchclinicalpractice.com/article/S01688227(19)31196-9/fulltext.
2 www.apma.org/files/FileDownloads/TR-JAPMA-Article.pdf
3 www.apma.org/files/FileDownloads/DukeStudy.pdf
18 APMA News March/April 2020

APMA News:
You were the 2018-19 APMA/TDI Public Health Fellow. How has
the fellowship played a role in shaping your career and driving your
research interests?
Dr. Albright:
In short, it has completely changed me for the better. We
all have had eye-opening experiences that change us-my
fellowship was one of those experiences. I have a new list of
goals and aspirations, and I assess myself differently than I
did before. I'm looking in a different direction and feel I have
a better grasp on what is important and what isn't. I think I
have more clarity than I did before in my career, and I think
I have a better idea of where I can be useful to the profession.
APMA News:
Are you working on any other research projects right now?
Dr. Albright:
I am working on a project I started in my fellowship that
I'm trying to continue with a new study design. The project is
looking at foot care exams and their association with hospital-

https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(19)31196-9/fulltext https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(19)31196-9/fulltext http://www.apma.org/files/FileDownloads/TR-JAPMA-Article.pdf http://www.apma.org/files/FileDownloads/DukeStudy.pdf

APMA News - March/April 2020

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