Abstract
OBJECTIVE: The aim of this study was to evaluate the effectiveness of WeChat-based remote care guidance as a supplement to standard care for patients with diabetic foot ulcers. Our specific objectives were to compare healing rates, self-management behaviors, and patient satisfaction between the two groups, with a focus on identifying patient subgroups that might benefit most from this approach. METHODS: A retrospective cohort study was conducted at Fujian Maternity and Child Health Hospital between June 2021 and December 2022, with follow-up until December 2024. Among 131 eligible patients with diabetic foot ulcers (Wagner grades 1-4), 59 received WeChat -based guidance (intervention) while 72 received standard care (control). Primary outcomes included wound healing rate and time-to-healing. Quality of life (WHOQOL-BREF) and treatment satisfaction (DTSQs) were assessed at baseline, 3, 6, 12, and 24 months. Analyses were adjusted for demographic characteristics, clinical parameters, and disease severity indicators. RESULTS: The intervention group showed significantly higher healing rates (88.1% vs 63.9%, P = 0.001) and faster healing time (HR = 2.27, 95% CI [1.35-3.82], P = 0.002). The effect was particularly pronounced in Wagner grade 2-3 ulcers (HR = 14.3-34.2, P < 0.001) and patients receiving interventional procedures (HR = 3.4, 95% CI [1.8-6.3], P <0.001). At 24 months, the intervention group demonstrated greater improvements in quality of life (mean difference = 7.87, P < 0.001) and treatment satisfaction (mean difference = 6.70, P < 0.001). CONCLUSION: WeChat-based remote care guidance was associated with better diabetic foot ulcer healing outcomes, particularly for moderate-severity ulcers and patients undergoing interventional procedures. Our findings also suggest associations between this approach and improvements in quality of life and treatment satisfaction.