ADOPTED PROJECT: Development of a decision aid for offloading device selection for people with diabetic foot ulceration

Principal Investigator: Dr Lindsey Cherry, Associate Professor University of Southampton  

Research team: Dr Emma Cowley, University of Southampton; Dr Michael Backhouse, Associate Professor, University of Warwick; Dr Kate Lippiet, University of Southampton & Wessex Cancer Alliance

Partners: University of Southampton & Solent NHS Trust, University of Warwick & Wessex Cancer Alliance

Lay Summary:We aim to create a visual tool, called a decision aid (DA). A DA shows the good and bad points for different treatment options. A DA can help people choose the best treatment for them. Helping people choose their treatment can make them healthier and happier in the longer term. We also aim to find out what is needed to support clinicians to use the DA.Treatments to help diabetic foot ulcers (DFUs) heal include a plaster cast or removeable boot. Both treatments have good and bad points. For example, we know casts tend to heal DFUs faster than boots, but you cannot drive with them. People can drive with a boot. Driving may be a priority for some people, to collect children or get to work, but healing quickly could be a priority for others.

Aim: To develop a shared decision aid (DA) for offloading device selection for people with diabetic foot ulceration; A secondary aim is to explore workforce willingness, confidence, and competence to use DAs and shared decision-making.

Methods: Two parallel workstreams (WS) will be completed. WS1 DA development will be undertaken in accordance with the International Patient Decision Aid Standards. The DA will likely contain information about a) the decision to be made, b) option risks and benefits, c) related values and d) decision next steps. WS2 Workforce readiness will be evaluated through a) scoping literature review, b) national workforce survey, and c) stakeholder focus group about workforce capability development, training needs, and implementation recommendations.

Expected outcomes: WS1 will produce a decision aid and the consolidation and generation of new partnerships ready for full trial evaluation. WS2 will identify priority areas to support workforce implementation of shared decision-making and DAs. This programme addresses multiple JLA priorities including PSP1, PSP2, PSP5 and PSP9. Additional benefits include research capacity growth in PSP areas through subsequent national multi-centre trial, with routes to support Advanced Clinical Practice and an embedded PhD studentship.