The Guyana Diabetes and Foot Care Project

A Complex Quality Improvement Intervention to Decrease Diabetes-Related Major Lower Extremity Amputations and Improve Diabetes Care in a Lower-Middle-Income Country

Citation: Lowe J, Sibbald RG, Taha NY, Lebovic G, Martin C, et al. (2015) The Guyana Diabetes and Foot Care Project: A Complex Quality Improvement Intervention to Decrease Diabetes-Related Major Lower Extremity Amputations and Improve Diabetes Care in a Lower-Middle-Income Country. PLoS Med 12(4): e1001814. doi:10.1371/journal.pmed.1001814
Published: April 21, 2015

Summary Points

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  • Type 2 diabetes is the fourth leading cause of death and affects 15.5% of the adult population in Guyana, South America.
  • Preintervention, 41.4% of individuals with diabetic foot complications experienced major lower extremity amputation at the national referral hospital.
  • A complex, interprofessional quality improvement intervention to improve diabetes and foot care was rolled out in two phases between 2008–2013.
  • We report the experience from this unique nationwide intervention, with a national referral hospital prototype (phase 1) regionalized to six administrative regions in Guyana comprising 89% of the population (phase 2).

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