Meghan Brennan, MD, MS | Managing Patients with Diabetic Foot Ulcers
Meghan Brennan, MD, MS, is an infectious disease physician whose research focuses on diabetic foot ulcers and health disparities. Her overall goal is to develop novel health system interventions that reduce major amputations among patients with diabetes, particularly those in rural areas.
Rural Disparities for Patients With Diabetic Foot Ulcers
Patients with diabetic foot ulcers in rural areas face 50 percent higher odds of major (above-ankle) amputation and 40 percent higher odds of death when compared to their urban counterparts. It isn’t clear why this disparity exists, although limited access to urban specialists (e.g. infectious disease specialists, vascular surgeons) is a factor.
Dr. Brennan is interested in using quantitative and qualitative methodology to explore this urban-rural disparity, and working alongside rural stakeholders to develop and test interventions to reduce major amputation rates.
Adjuvant Rifampin for Osteomyelitis Complicating Diabetic Foot Ulcers
Adding rifampin to a backbone antibiotic regimen to treat osteomyelitis in patients with diabetic foot ulcers may improve outcomes. Dr. Brennan is part of a national team conducting a randomized control trial answering this question (VA INTREPID trial).
Predicting Wound Healing Based Upon the Microbiome
Dr. Brennan is collaborating with Dr. Lindsay Kalan, a microbiologist, to identify predictors of healing based on the wound microbiome, including microbiome composition, microorganism-microrganism interactions, and host-microorganism interactions. They are using a prospective cohort design and next generation sequencing to answer these questions.
Crossing the Divide
Dr. Brennan is working with rural health clinics throughout Wisconsin to pilot an integrated care model that facilitates collaboration across the rural-urban divide for patients with diabetic foot ulcers.
- Brennan MB, Powell WR, Kaiksow F, Kramer J, Liu Y, Kind AJH, Bartels CM. Association of race, ethnicity, and rurality with major leg amputation or death among Medicare beneficiaries hospitalized with diabetic foot ulcers. JAMA Netw Open. 2022:5(4):e228399. doi: 10.1001/jamanetworkopen.2022.8399. PMID: 35446395; PMCID: PMC9024392
- Musuuza J, Sutherland BL, Kurter S, Balasubramanian P, Bartels CM, Brennan MB. A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. J Vasc Surg. 2020 Apr;71(4):1433-1446.e3. doi: 10.1016/j.jvs.2019.08.244. Epub 2019 Oct 30. PMID: 31676181; PMCID: PMC7096268.
- Brennan MB, Allen GO, Ferguson PD, McBride JA, Crnich CJ, Smith MA. The Association Between Geographic Density of Infectious Disease Physicians and Limb Preservation in Patients With Diabetic Foot Ulcers. Open Forum Infect Dis. 2017 Feb 20;4(1):ofx015. doi: 10.1093/ofid/ofx015. PMID: 28480286; PMCID: PMC5413995.
Dr. Brennan's research is funded by the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases and a Department of Medicine Medical Education Innovation grant.
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