Patient and Health Professional Perceptions of the Assessment, Diagnosis and Management of Acute Charcot Neuro-Osteoarthropathy at a Regional Australian Health Service.

Abstract

Background: Acute Charcot neuroarthropathy (CN) is a rare but serious complication of diabetes that requires timely diagnosis and evidence-based management to prevent long-term disability. In regional or rural settings, delivering evidence-based care is particularly challenging due to systemic and contextual barriers.

Objective: To explore the perceptions of patients and health professionals about assessment, diagnosis and management of acute CN in a regional Victorian health service.

Method: This study used a qualitative research design, utilising thematic analysis of semi-structured interviews with patients with previous acute CN and focus groups with health professionals (orthopaedic surgeons, podiatrists and prosthetists and orthotists) involved in the assessment and management of patients with acute CN. Two assessors used inductive thematic analysis to identify key themes related to acute CN care delivery.

Results: Four overarching themes were identified: (1) barriers to evidence-based care, including delayed diagnosis, limited access to skilled clinicians and diagnostic tools and the burden of treatment; (2) enablers, such as timely access to knowledgeable clinicians and resources; (3) mitigating factors, including patient engagement, empathetic communication and multidisciplinary support and (4) strategies for improvement, such as public and professional education, upskilling of health professionals and integration of psychological and person-centred support.

Conclusion: Improving outcomes for people with acute CN in regional or rural settings requires a multifaceted approach. Enhancing awareness, building workforce capacity and embedding patient-centred care practices are essential to ensure timely diagnosis, equitable access to treatment and improved quality of life.