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Footcare
‘Let’s talk foot care with patients’ From my experience working in private podiatry practice, most podiatry treatment consultations end with instructions for the patient to attend their local pharmacy. Here, they can buy the necessary products needed to maintain their feet in good health in between podiatry appointments. Written by Rebecca Conway – BSc (Hons) Podiatrist, Dundrum Podiatry Clinic
Medical Services) Chiropody Card scheme. With a Chiropody card, patients can access 4-6 podiatry treatments annually, either for free or at a subsidised rate.There are also various circumstances in which people will have priority in accessing their local HSE podiatry services. Local HSE authorities and websites such as www.citizensinformation.ie can be a great resource for patients and professionals with detailed information on eligibility criteria for different services. Is there potential for collaborative working and multidisciplinary teamwork in foot care?
An example of this is a patient I recently advised of using 10% urea-based emollient for anhidrotic skin on their heels. This patient had Rheumatoid Arthritis and various other comorbidities. On instruction, this patient attended their pharmacy, where they were advised of an appropriate emollient with a pump handle and directions for use reiterated to them. The patient was then able to apply the emollient daily and prevent cracks in the skin of their heels. As a result, a break in the skin epidermis was prevented, meaning an ulceration and portal for infection prevented. This situation is one we see regularly as podiatrists, it is being prevented here though a multidisciplinary approach employed from podiatrist and pharmacist. Patients see their podiatrists semi-regularly. It varies between 4-6 times a year with the medical card scheme, or privately when necessary. It would be rare for a patient to be attending their podiatrist more than once a month unless it is to resolve a particular ailment such as a verruca. Conversely, pharmacists may see patients much more regularly, up to multiple times a week. It is often the community pharmacists who direct many patients to the podiatrist when appropriate and recommend necessary foot health products to our patients.
In Dundrum podiatry, we are lucky to have a good working relationship with our local community pharmacy and can see first-hand the difference the team makes to our patients’ (foot) health. As podiatrists, we often write the product name or type down for the patient who then brings it to their pharmacist. We are grateful to the pharmacist who takes the time to advise the patient accordingly and is readily stocked with the products which the patients require. How can we promote foot care to patients? As a podiatrist, one way we promote foot care to patients is through health education. This is not just by educating the patient about their foot health but also through educating ourselves as professionals. By keeping up to date with new treatments available to patients, continued professional development and relevant evidence-based articles, we can continue to broaden our knowledge of foot health. Another way of promoting good foot health is by informing patients of foot health services which they can avail themselves of. People who have a health condition which is known to have a detrimental effect on their foot health such as Diabetes or medical card holders who are of a certain age (66+) may be eligible for the GMS (General
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As mentioned before, a collaborative and multidisciplinary approach is fundamental in achieving a high standard of care for our patients. Rarely do patients attend only one healthcare professional for resolution or management of a disease or ailment. Multidisciplinary teamwork across healthcare settings improves the quality of life and treatment outcomes for our patients. Therefore, it is important for pharmacists and podiatrists to know when to refer patients to each other. From a podiatrist’s perspective, it varies for different common ailments. For example, verrucae often start off being treated by patients with over-the-counter topical medicines, frequently consisting of a lower percentage of salicylic acid. However if a patient is compromised is immunocompromised, they must attend their podiatrist or G.P.
Similarly, if the patient is reporting multiple verrucae on a foot, the chance is they are Mosaic Verrucae, which are much more resistant to over-the-counter treatments and may need podiatry or G.P services. Another common example we see every day is Fungal Nails (Onychomycosis). The list of overthe-counter fungal nail remedies is endless. However, as it is a fungal infection, it can spread from nail to nail and person to person. It is important to prevent infection spreading, by ensuring that there is no cross-contamination present such as a nail file shared between family members. There are creams and powders useful such as Daktarin and Desenex in preventing Tinea Pedis. Fungal nail infections often cause painful, thickened nails which would need to be reduced and cut back by a Podiatrist. There are several podiatrists in Ireland who are based on the site of the pharmacy, so interdisciplinary communication can be achieved without significant effort. More information about your local podiatrist can be found by using the Podiatry Ireland website (www.podiatryireland.ie), where there is a search bar to find podiatrists, either by name or area. This website has been created by The Society of Chiropodist and Podiatrist of Ireland and can be used to find out more about Podiatry in Ireland.
