48 Development of a multifactorial intervention to improve cardiovascular outcomes in adults with type 2 diabetes and diabetes-related foot ulcers

<h3>Background</h3> Approximately one in four people with diabetes develop diabetes-related foot ulcer disease (DFUD) exposing them to lower quality of life and higher risk of morbidity and mortality. Existing diabetes self-management recommendations (e.g., increase physical activity) are unsuitable, and tailored interventions do not exist. <h3>Aim</h3> To develop a multifactorial intervention to improve cardiovascular risk awareness, risk factor management, medication optimisation, psychosocial outcomes and promote behaviour change, in adults with type 2 diabetes and DFUD. <h3>Methods</h3> The intervention was developed by a multi-disciplinary team, including healthcare professionals with expertise in foot care and cardiovascular disease, physiotherapists, and experts in physical activity, nutrition and psychology. The intervention is underpinned by the Capability, Opportunity, Motivation (COM-B) model, informed by guidelines, patient and public involvement (PPI), and a qualitative study. <h3>Results</h3> Guided by Behaviour Change Techniques (e.g. <i>information provision</i> and <i>problem solving</i>), the intervention consists of three components: 1:1 session delivered by a clinician or a diabetes specialist nurse; a self-management education programme including practical sessions on physical activity exercises; and a tailored digital-based self-management programme, including bespoke chair-based exercise videos. <h3>Conclusion</h3> This intervention meets the unmet needs and has the potential to reduce risk of cardiovascular events for this priority population and is currently tested in a randomised controlled trial in Leicester and other UK sites.