I was wondering what your views may be on doing on demand or routine doppler ABPI in addition to clinical evaluation of circulation and vascular condition?
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One of the care homes for people with severe learning difficulties that visit us regularly have asked for routine ABPI - dopler tests. When I enquired WHY? they explained that they had been on a CPD course that recommended regular monitoring of vascular condition and circulation using these test and that they could ask their chiropodist /podiatrist to do them.
I explained that I did not think regular routine evaluation using doppler - ABPI was necessary when there were no other signs or symptoms of cardio vascular disease or compromised blood circulation that could be seen by simple clinical visual examination. They insisted and so I am doing these tests, which also attract and extra fee on top of the normal chiropody fee.
Some of the clients do have a lowish ABPI, 0.8 nominal, and biphasic sounds but what would the GP or vascular specialist do with that information when there are no other presentations, signs or symptoms of concomitant morbidities and have no other disease such as diabetes that would increase risk of potential pathologies.
Your views would be appreciated.
Dave Smith
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