Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year.
ACP does not support QPP 163: “Diabetes: Foot Exam.” Although we recognize the value of performing foot exams in diabetic patients, particularly visual inspection and sensory exam, there is a lack of high-quality evidence to support the benefit of regularly performed pulse exams on patient outcomes, especially for asymptomatic patients. Therefore, we do not support this measure because it calls for all three elements included in the foot exam. There is no evidence evaluating the benefit of pulse exam on patient outcomes (e.g., downstream ulceration) and routine screening in asymptomatic patients could lead to overuse of Ankle Brachial Index (ABI) and procedures for peripheral arterial disease that may not be beneficial. A better measure may focus on addressing vascular risk in all patients with an emphasis on statin treatment, blood pressure control and smoking cessation.