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Follow-up consultations via telemedicine may be an effective alternative to face-to-face consultations for patients suffering from foot ulcerations

Nordheim LV, Haavind MT, and Iversen MM.  Effect of telemedicine follow-up care of leg and foot ulcers: A systematic review  BMC Health Services Research. November 2014;14(565).

Review question

Are follow-up healthcare consultations delivered remotely by information communication technology (ICT) as effective as face-to-face consultations for patients suffering from leg and foot ulcers?


Leg ulcers and diabetes-related foot ulcers are frequent and costly complications associated with chronic diseases. An aging population will likely increase the prevalence of these conditions in coming decades.

Treatment of leg and foot ulcers requires that patients travel frequently to healthcare facilities to receive face-to-face primary and specialist follow-up care, which poses a large burden on the patient.

Follow-up consultations could alternatively be delivered via telemedicine, which involves using ICT to connect patients and healthcare workers. Delivering consultations via telemedicine is a promising means of reducing the travel burden on patients suffering from leg and foot ulcers.

How the review was done

A detailed search of a number of electronic databases up to and including May 2014 was conducted. Studies that focused on ICT and its influence on healing time, interaction between patient and healthcare professional, and improving cooperation between healthcare professionals treating patients suffering from leg and foot ulcers, were included.

A total of 20 studies were identified in searches, and just one was included in the review after assessments for eligibility.

This review was funded by Bergen University College, Norway.

What the researchers found

The single study included in the review compared the effect of real-time interactive video consultations with face-to-face follow-up care for patients with foot ulcers. Patient healing time and number of ulcers after 12 weeks was measured.

The healing time for patients in the telemedicine and control groups were found to be similar, suggesting  telemedicine could be used to reduce the burden of travel, without negative health outcomes.

Despite these positive findings, the findings from this single study should be viewed cautiously given the potential for biased results. 


Patients receiving follow-up care for foot ulcers via telemedicine may have a reduced travel burden without any negative effect on their health, however, definitive conclusions can’t be made given a limited evidence base. Larger and more rigorous studies are needed before firm conclusions can be made.



Control group
A group that receives either no treatment or a standard treatment.

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