Canadian Patient Perspectives on Facilitators and Barriers to Diabetic Foot Ulcer Care: A Scoping Review

OBJECTIVE: To review Canadian patient and caregiver perspectives on the facilitators and barriers to diabetic foot ulcer (DFU) care. METHODS: We conducted a scoping review in collaboration with a patient partner, following the Preferred Reporting Items for Systematic Reviews guidelines (PRISMA-ScR). Grey literature and primary studies from Medline, CINAHL and EMBASE were searched from inception to February 2024. Studies of adults with active or healed DFUs and their caregivers were included. Data were independently screened and extracted by two reviewers and key themes were synthesized collaboratively. RESULTS: Twenty-two studies representing 400 patients or caregivers were included, with most individuals living in Ontario (n=15 articles, 68.1%). Five overarching themes capturing facilitators and barriers to DFU care were identified: Prevention, Access to Care, Patient Education, Wound Care, and Patient Impact. Reported barriers included emotional distress, limited mobility, low awareness of self-management strategies, and delayed referrals, while key facilitators involved caregiver and community support as well as education from healthcare providers. CONCLUSIONS: Canadian diabetic foot screening and DFU treatment (preservation) programs should focus on improving access, empowering patients through education, and leveraging community support partners to promote self-management and amputation prevention.