Diabetic Foot Ulcers: Impact on Quality of Life and Instruments for Its Measurement

Khairunisa Qomariyanti (1) , Rani Sauriasari (2) , Ratu Ayu Dewi Sartika (3)
(1) University of Indonesia , Indonesia
(2) University of Indonesia , Indonesia
(3) University of Indonesia , Indonesia

Abstract

Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, significantly impacting patients' quality of life (QoL) due to the heightened risk of infection and amputation. Pharmacists play a crucial role in managing diabetes and its complications, and assessing QoL can be a valuable tool for monitoring treatment success and medication effectiveness. This review explores instruments used to measure QoL in patients with DFUs, encompassing both general and disease-specific tools. We examine the impact of DFUs on QoL and discuss various theoretical frameworks used to understand this complex relationship.

Full text article

Generated from XML file

References

1. Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee. IDF Diabetes Atlas. 10th edition. Brussels: International Diabetes Federation; 2021. PMID: 35914061
2. Dayya D, O’Neill OJ, Huedo-Medina TB, Habib N, Moore J, Iyer K. Debridement of Diabetic Foot Ulcers. Adv Wound Care. 2022;11(12):666–86. DOI: 10.1089/wound.2021.0016; PMCID: PMC9527061; PMID: 34376065
3. Jiang P, Li Q, Luo Y, Luo F, Che Q, Lu Z, et al. Current status and progress in research on dressing management for diabetic foot ulcer. Front Endocrinol. 2023;14:1221705. DOI: 10.3389/fendo.2023.1221705; PMCID: PMC10470649; PMID: 37664860
4. Chen CY, Wu RW, Hsu MC, Hsieh CJ, Chou MC. Adjunctive Hyperbaric Oxygen Therapy for Healing of Chronic Diabetic Foot Ulcers: A Randomized Controlled Trial. J Wound Ostomy Continence Nurs. 2017;44(6):536–545. DOI: 10.1097/won.0000000000000374; PMID: 28968346
5. Everett E, Mathioudakis N. Update on Management of Diabetic Foot Ulcers. Ann N Y Acad Sci. 2018;1411(1):153–65. DOI: 10.1111/nyas.13569; PMCID: PMC5793889; PMID: 29377202
6. Jayalakshmi MS, Thenmozhi P, Vijayaragavan R. Impact of chronic wound on quality of life among diabetic foot ulcer patients in a selected hospital of Guwahati, Assam, India. Ayu. 2020;41(1):19-23. DOI: 10.4103/ayu.ayu_33_20; PMCID: PMC8415236; PMID: 34566380
7. Sriram S, Chack LE, Ramasamy R, Ghasemi A, Ravi TK, Sabzghabaee AM. Impact of Pharmaceutical Care on Quality of Life in Patients with Type 2 Diabetes Mellitus. J Res Med Sci. 2011;16(Suppl 1):412–8. PMCID: PMC3252774; PMID: 22247727
8. Sallom H, Abdi A, Halboup AM, Başgut B. Evaluation of pharmaceutical care services in the Middle East Countries: a review of studies of 2013-2020. BMC Public Health. 2023;23(1):1364. DOI: 10.1186/s12889-023-16199-1; PMCID: PMC10351150; PMID: 37461105
9. Németh G. Health related quality of life outcome instruments. Eur Spine J. 2006;15 (Suppl 1):S44-51. DOI: 10.1007/s00586-005-1046-8; PMCID: PMC3454556; PMID: 16320032
10. Kiling IY, Kiling-Bunga BN. Pengukuran dan Faktor Kualitas Hidup pada Orang Usia Lanjut. J Health Behav Sci. 2019;1(3):149–65. DOI: 10.35508/jhbs.v1i3.2095
11. Jais S. Various Types of Wounds That Diabetic Patients Can Develop: A Narrative Review. Clin Pathol. 2023;16:2632010X231205366. DOI: 10.1177/2632010X231205366
12. Raja JM, Maturana MA, Kayali S, Khouzam A, Efeovbokhan N. Diabetic foot ulcer: A comprehensive review of pathophysiology and management modalities. World J Clin Cases. 2023;11(8):1684-94. DOI: 10.12998/wjcc.v11.i8.1684; PMCID: PMC10037283; PMID: 36970004
13. Frykberg RG, Banks J. Challenges in the Treatment of Chronic Wounds. Adv Wound Care. 2015;4(9):560-82. DOI: 10.1089/wound.2015.0635; PMCID: PMC4528992; PMID: 26339534
14. Lim JZM, Ng NSL, Thomas C. Prevention and Treatment of Diabetic Foot Ulcers. J R Soc Med. 2017;110(3):104–9. DOI: 10.1177/0141076816688346; PMCID: PMC5349377; PMID: 28116957
15. Bandyk DF. The Diabetic Foot: Pathophysiology, Evaluation, and Treatment. Semin Vasc Surg. 2018;31(2–4):43–8. DOI: 10.1053/j.semvascsurg.2019.02.001; PMID: 30876640
16. Nowak NC, Menichella DM, Miller R, Paller AS. Cutaneous innervation in impaired diabetic wound healing. Transl Res. 2021;236:87-108. DOI: 10.1016/j.trsl.2021.05.003; PMCID: PMC8380642; PMID: 34029747
17. Sari Y, Yusuf S, Haryanto H, Sumeru A, Saryono S. The barriers and facilitators of foot care practices in diabetic patients in Indonesia: A qualitative study. Nurs Open. 2022;9(6):2867-77. DOI: 10.1002/nop2.993; PMCID: PMC9584460; PMID: 34411445
18. Wang X, Yuan CX, Xu B, Yu Z. Diabetic foot ulcers: Classification, risk factors and management. World J Diabetes. 2022;13(12):1049-65. DOI: 10.4239/wjd.v13.i12.1049; PMCID: PMC9791567; PMID: 36578871
19. Edmonds M, Manu C, Vas P. The current burden of diabetic foot disease. J Clin Orthop Trauma. 2021;17:88-93. DOI: 10.1016/j.jcot.2021.01.017; PMCID: PMC7919962; PMID: 33680841
20. Giazcomozzi C, Sartor CD, Telles R, Uccioli L, Sacco ICN. Ulcer-risk Classification and Plantar Pressure Distribution in Patients with Diabetic Polyneuropathy: Exploring the Factors that can Lead to Foot Ulceration. Ann Ist Super Sanità. 2018;54(4):284–93. DOI: 10.4415/ann_18_04_04; PMID: 30575564
21. Aqtam I, Ayed A, Zaben K. Quality of Life: Concept Analysis. Saudi J Nurs Health Care. 2023;6(1):10-5. DOI: 10.36348/sjnhc.2023.v06i01.003
22. Beslerová S, Dzuričková J. Quality of Life Measurements in EU Countries. Proced Econ Financ. 2014;12:37–47. DOI: 10.1016/s2212-5671(14)00318-9
23. Nemcová J, Hlinková E, Farský I, Žiaková K, Jarošová D, Zeleníková R, et al. Quality of Life in Patients with Diabetic Foot Ulcer in Visegrad Countries. J Clin Nurs. 2017;26(9–10):1245–56. DOI: 10.1111/jocn.13508; PMID: 27539540
24. Coffey L, Mahon C, Gallagher P. Perceptions and experiences of diabetic foot ulceration and foot care in people with diabetes: A qualitative meta-synthesis. Int Wound J. 2019;16(1):183–210. DOI: 10.1111/iwj.13010; PMCID: PMC7949356; PMID: 30393976
25. Vedhara K, Beattie A, Metcalfe C, Roche S, Weinman J, Cullum N, et al. Development and preliminary evaluation of a psychosocial intervention for modifying psychosocial risk factors associated with foot re-ulceration in diabetes. Behac Res Ther. 2012;50(5):323–32. DOI: 10.1016/j.brat.2012.02.013; PMID: 22459731
26. Crocker RM, Palmer KNB, Marrero DG, Tan TW. Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. J Diabetes Complications. 2021;35(8):107960. DOI: 10.1016/j.jdiacomp.2021.107960; PMCID: PMC8316286; PMID: 34059410
27. Jaksa PJ, Mahoney JL. Quality of life in patients with diabetic foot ulcers: Validation of the Cardiff Wound Impact Schedule in a Canadian population. Int Wound J. 2010;7(6):502–7. DOI: 10.1111/j.1742-481X.2010.00733.x; PMCID: PMC7951786; PMID: 20860554
28. Goodridge D, Trepman E, Embil JM. Health-related quality of life in diabetic patients with foot ulcers: literature review. J Wound Ostomy Continence Nurs. 2005;32(6):368–77. DOI: 10.1097/00152192-200511000-00007; PMID: 16301902
29. Alrub AA, Hyassat D, Khader YS, Bani-Mustafa R, Younes N, Ajlouni K. Factors Associated with Health-Related Quality of Life among Jordanian Patients with Diabetic Foot Ulcer. J Diabetes Res. 2019;2019:4706720. DOI: 10.1155/2019/4706720; PMCID: PMC6360050; PMID: 30800685
30. Khunkaew S, Fernandez R, Sim J. Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Qual Life Res. 2019;28(6):1413–27. DOI: 10.1007/s11136-018-2082-2; PMID: 30565072
31. Muzakkir, Yunding M, Yunding J, Harli K. The Relationship of Psychological Stress on Diabetic Wound Healing Processes: A Literature Review. J Pharm Negat Results. 2022;13(S01):879–82. DOI: 10.47750/pnr.2022.13.s01.106
32. Kurdi F, Kholis AH, Hidayah N, Fitriasari M. Stress Pasien Dengan Ulkus Kaki Diabetikum Di Al Hijrah Wound Care Center Jombang. J Ilmiah Keperawatan Sci J Nurs. 2020;6(1):128–36. DOI: 10.33023/jikep.v6i1.577
33. Sari Y, Purnawan I, Taufik A, Sumeru A. Quality of Life and Associated Factors in Indonesian Diabetic Patients with Foot Ulcers. Nurse Media J Nurs. 2018;8(1):13-24. DOI: 10.14710/nmjn.v8i1.16815
34. Utami DT, Karim D, Agrina. Faktor-faktor yang Mempengaruhi Kualitas Hidup Pasien Diabetes Mellitus dengan Ulkus Diabetikum. J Online Mahasiswa Program Studi Ilmu Keperawatan Universitas Riau. 2014;1(2):1–7.
35. Baroroh F, Solikah WY, Urfiyya QA. Analisis Biaya Terapi Diabetes Melitus Tipe 2 Di Rumah Sakit PKU Muhammadiyah Bantul Yogyakarta. J Farmasi Sains Praktis. 2016;1(2):11–22. DOI: 10.31603/pharmacy.v1i2.230
36. Abetz L, Sutton M, Brady L, McNulty P, Gagnon DD. The Diabetic Foot Ulcer Scale (DFS): a quality of life instrument for use in clinical trials. Pract Diabetes Int. 2002;19(6):167–75. DOI: 10.1002/pdi.356
37. MAPI Research Trust. DFS-SF Information Booklet, 1st Edition (Issue February). Lyon: MAPI Research Trust; 2011.
38. Martinez-Gonzalez D, Dòria M, Martínez-Alonso M, Alcubierre N, Valls J, Verdú-Soriano J, et al. Adaptation and Validation of The Diabetic Foot Ulcer Scale-Short Form in Spanish Subjects. J Clin Med. 2020;9(8):2497. DOI: 10.3390/jcm9082497; PMCID: PMC7465700; PMID: 32756508
39. Macioch T, Sobol E, Krakowiecki A, Mrozikiewicz-Rakowska B, Kasprowicz M, Hermanowski T. Health related quality of life in patients with diabetic foot ulceration - translation and Polish adaptation of Diabetic Foot Ulcer Scale short form. Health Qual Life Outcomes. 2017;15(1):15. DOI: 10.1186/s12955-017-0587-y; PMCID: PMC5251239; PMID: 28109278
40. Kontodimopoulos N, Veniou A, Tentolouris N, Niakas D. Validity and Reliability of the Greek Version of the Diabetic Foot Ulcer Scale-Short Form (DFS-SF). Hormones. 2016;15(3):394–403. DOI: 10.14310/horm.2002.1682; PMID: 27394704
41. Ma L, Ma W, Lin S, Li Y, Ran X. Adaptation and Validation of the Diabetic Foot Ulcer Scale-Short Form Scale for Chinese Diabetic Foot Ulcers Individuals. Int J Environ Res Public Health. 2022;19(21):14568. DOI: 10.3390/ijerph192114568; PMCID: PMC9659257; PMID: 36361446
42. Rezaie W, Lusendi F, Doggen K, Matricali G, Nobels F. Health-related Quality of Life in Patients with Diabetic Foot Ulceration: Study Protocol for Adaptation and Validation of Patient-reported Outcome Measurements (PROMs) in Dutch-speaking Patients. BMJ Open. 2019;9(12):e034491. DOI: 10.1136/bmjopen-2019-034491; PMCID: PMC7008415; PMID: 31874898
43. Lee YN. Translation and Validation of the Korean Version of the Diabetic Foot Ulcer Scale-Short Form. Int Wound J. 2019;16(Suppl 1):3–12. DOI: 10.1111/iwj.13025; PMCID: PMC7948823; PMID: 30793855
44. Raju BN, Mateti UV, Mohan R, D'Souza C, Shastry CS, D'Souza N. Transcultural adaptation of the Malayalam version of the diabetic foot ulcer scale-short form. Clin Epidemiol Glob Health. 2022;18:101190. DOI: 10.1016/j.cegh.2022.101190
45. Price P, Harding K. Cardiff Wound Impact Schedule: the development of a condition-specific questionnaire to assess health-related quality of life in patients with chronic wounds of the lower limb. Int Wound J. 2004;1(1):10–7. DOI: 10.1111/j.1742-481x.2004.00007.x; PMCID: PMC7951606; PMID: 16722893
46. Granado-Casas M, Martinez-Gonzalez D, Martínez-Alonso M, Dòria M, Alcubierre N, Valls J, et al. Psychometric validation of the cardiff wound impact schedule questionnaire in a spanish population with diabetic foot ulcer. J Clin Med. 2021;10(17):4023. DOI: 10.3390/jcm10174023; PMCID: PMC8432453; PMID: 34501471
47. Abbasi-Ghahramanloo A, Soltani-Kermanshahi M, Mansori K, Khazaei-Pool M, Sohrabi M, Baradaran HR, et al. Comparison of sf-36 and whoqol-bref in measuring quality of life in patients with type 2 diabetes. Int J Gen Med. 2020;13:497–506. DOI: 10.2147/IJGM.S258953; PMCID: PMC7434519; PMID: 32884330
48. Lee WJ, Song KH, Noh JH, Choi YJ, Jo MW. Health-related quality of life using the EuroQol 5D questionnaire in Korean patients with type 2 diabetes. J Korean Med Sci. 2012;27(3):255–60. DOI: 10.3346/jkms.2012.27.3.255; PMCID: PMC3286771; PMID: 22379335
49. Matter-Walstra K, Klingbiel D, Szucs T, Pestalozzi BC, Schwenkglenks M. Using the EuroQol EQ-5D in Swiss cancer patients, which value set should be applied? Pharmacoeconomics.2014;32(6):591–9. DOI:10.1007/s40273-014-0151-0; PMID: 24671924
50. Abedini MR, Bijari B, Miri Z, Shakhs FS, Abbasi A. The quality of life of the patients with diabetes type 2 using EQ-5D-5 L in Birjand. Health Qual Life Outcomes. 2020;18(1):18. DOI: 10.1186/s12955-020-1277-8; PMCID: PMC6990543; PMID: 32000785
51. Kheir NM, van Mil JWF, Shaw JP, Sheridan JL. Health-related Quality of Life in Pharmaceutical Care - Targeting an Outcome That Matters. Pharm World Sci. 2004;26(3):125–8. DOI: 10.1023/b:phar.0000026811.37414.4f; PMID: 15230357
52. Yordanova S, Petkova V, Petrova G, Dimitrov M, Naseva E, Dimitrova M, et al. Comparison of health-related quality-of-life measurement instruments in diabetic patients. Biotechnol Biotechnol Equip. 2014;28(4):769–74. DOI: 10.1080/13102818.2014.935572; PMCID: PMC4434102; PMID: 26019561
53. Jeffcoate WJ, Price PE, Phillips CJ, Game FL, Mudge E, Davies S, et al. Randomised controlled trial of the use of three dressing preparations in the management of chronic ulceration of the foot in diabetes. Health Technol Assess. 2009;13(54):1–86. DOI: 10.3310/hta13540; PMID: 19922726

Authors

Khairunisa Qomariyanti
nisa.qomariyanti@gmail.com (Primary Contact)
Rani Sauriasari
Ratu Ayu Dewi Sartika
Author Biographies

Khairunisa Qomariyanti, University of Indonesia

Master Program of Pharmaceutical Sciences, Universitas Indonesia, Depok, West Java, Indonesia

Rani Sauriasari, University of Indonesia

Department of Pharmaceutical Sciences, Universitas Indonesia, Depok, West Java, Indonesia

Ratu Ayu Dewi Sartika, University of Indonesia

Department of Public Health, Universitas Indonesia, Depok, West Java, Indonesia

1.
Qomariyanti K, Sauriasari R, Sartika RAD. Diabetic Foot Ulcers: Impact on Quality of Life and Instruments for Its Measurement. Borneo J Pharm [Internet]. 2024May30 [cited 2024Dec.22];7(2):215-23. Available from: https://journal.umpr.ac.id/index.php/bjop/article/view/6554

Article Details