Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

Waaijman, Roelof; Keukenkamp, Renske; Haart, Mirjam de; Polomski, Wojtek; Nollet, Frans; Bus, Sicco A.

doi:10.2337/dc12-1330

Cited by 147 publications

(248 citation statements)

References 26 publications

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“…This low level of foot care behavior identified by this study corroborates previous research that revealed inadequacies of foot care practice, and indicated that the majority of patients fail to get the appropriate size of footwear, and they do not inspect inside their footwear or indeed inspect their feet sufficiently (Waaijman, 2013). In this respect, Bell et al (2005) reported that the degree to which a person is able to perform diabetes foot self-care is likely to be influenced by a number of factors, including personal health, access to medical care and foot care education, and formal and informal support.…”

Section: Discussionsupporting

confidence: 73%

Association between Patient Interpretation of Diabetic Peripheral Neuropathy and Foot Self-Care Behaviors

Ahmed¹

2018

IJND

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Foot-related disease is the most common cause of hospital admissions among the diabetic population. Diabetic foot ulcer-related morbidity could be ultimately prevented by positive patients" interpretation of peripheral neuropathy and active engagement in foot self-care. Objective: To identify the association between patient interpretation of diabetic peripheral neuropathy and foot self-care behaviors. Methods: A convenience sample of 121 adult diabetic patients with either type I or II diabetes were recruited from diabetic clinic at Gamal Abdel Nasar Hospital in Alexandria, Egypt. Four tools were used in the research study (Bio Sociodemographic Sheet, Modified Neuropathy Disability Score, Patient Interpretation Neuropathy (PIN) Questionnaire, and Foot Self-Care Behaviors Questionnaire). Results: More than a third of patients have moderate peripheral neuropathy. Patients with no past history of foot ulcer obtained higher mean score of illness identity and causes. These differences were found to be highly statistically significant. The severity of peripheral neuropathy greatly affected patients" interpretation of peripheral neuropathy. The findings also indicated that there are significant differences between patients" foot self-care behaviors and their interpretation of peripheral neuropathy. Patients who have adequate foot self-care obtained higher mean score than those with inadequate foot self-care behaviors related to all items of peripheral neuropathy interpretations except items related to illness identity and causes. Conclusion:The results highlight the importance of assessment and understanding patients" interpretation of peripheral neuropathy to promote foot self-care behavior and prevent diabetic foot complications.

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Section: Discussionsupporting

confidence: 73%

Association between Patient Interpretation of Diabetic Peripheral Neuropathy and Foot Self-Care Behaviors

Ahmed¹

2018

IJND

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“…In other words, prescribed footwear can only be effective in preventing DFUs if worn by the patient. 37 Several studies have suggested that high risk patients wear their prescribed footwear during only 15-28% of their total daily activities. [38][39][40] While education could play an important role in enhancing patient adherence to prescribed footwear, 41 recent studies suggest that without frequent education, the adherence could be diminished over time.…”

Section: Discussionmentioning

confidence: 99%

Smarter Sole Survival: Will Neuropathic Patients at High Risk for Ulceration Use a Smart Insole-Based Foot Protection System?

Najafi

Ron

Enriquez

et al. 2017

J Diabetes Sci Technol

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Objective: This study examined adherence to alert-based cues for plantar pressure offloading in patients with diabetic foot disease. Method and Design: Participants (n = 17) with in diabetic foot remission (history of neuropathic ulceration) were instructed to wear a smart insole system (the SurroSense Rx, Orpyx Medical Technologies Inc, Calgary, Canada) over a three-month period. This device is designed to cue offloading to manage unprotected sustained plantar pressures in an effort to prevent foot ulceration. A successful response to an alert was defined as pressure offloading, which occurred within 20 minutes of the alert onset. Patient adherence, defined as daily hours of device wear, was determined using sensor data and patient questionnaires. Changes in these parameters were assessed monthly. Results: Patients demonstrating increased adherence over the course of the study received more alerts (0.82 ± 0.31 alerts/hour) than patients whose adherence did not improve (0.36 ± 0.46 alerts/hour, P = .156). By the final stages of the study, participants who had received at least one alert every two hours were more adherent with offloading than participants who received fewer alerts (52.5 ± 4.1% vs 24.7 ± 22.4%, P = .043). Furthermore, duration of time from alert generation to successful offloading was significantly greater in the group receiving fewer alerts. This was measured in the third month with an effect size Cohen’s d = 1.739, P = .043. Conclusion: The results suggest a minimum number of alerts (one every two hours) is required for patients with diabetic neuropathy to optimally respond to offloading cues from a smart insole system.

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“…Additionally, patients were classified based on a measured in-shoe peak pressure ,200 kPa (15,27,28) and adherence .80% (29). This parameter, WP, and CPTS were included in the analysis.…”

Section: Independent Risk Factorsmentioning

confidence: 99%

Risk Factors for Plantar Foot Ulcer Recurrence in Neuropathic Diabetic Patients

et al. 2014

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OBJECTIVERecurrence of plantar foot ulcers is a common and major problem in diabetes but not well understood. Foot biomechanics and patient behavior may be important. The aim was to identify risk factors for ulcer recurrence and to establish targets for ulcer prevention. RESEARCH DESIGN AND METHODSAs part of a footwear trial, 171 neuropathic diabetic patients with a recently healed plantar foot ulcer and custom-made footwear were followed for 18 months or until ulceration. Demographic data, disease-related parameters, presence of minor lesions, barefoot and in-shoe plantar peak pressures, footwear adherence, and daily stride count were entered in a multivariate multilevel logistic regression model of plantar foot ulcer recurrence. RESULTSA total of 71 patients had a recurrent ulcer. Significant independent predictors were presence of minor lesions (odds ratio 9.06 [95% CI 2.98-27.57]), day-to-day variation in stride count (0.93 [0.89-0.99 CONCLUSIONSThe presence of a minor lesion was clearly the strongest predictor, while recommended use of adequately offloading footwear was a strong protector against ulcer recurrence from unrecognized repetitive trauma. These outcomes define clear targets for diabetic foot screening and ulcer prevention.In patients with diabetes, foot ulcers are a serious risk for infection and amputation (1). The prevention of foot ulcers is important to avoid these devastating outcomes. Several studies have identified risk factors for diabetic foot ulceration, which include, among others, peripheral neuropathy, peripheral arterial disease, and foot deformity (2-7). The strongest predictors of ulceration are presence of peripheral neuropathy and a history of ulceration, which shows that ulcers often recurdup to 40% annually (8). Ulcer recurrence significantly increases long-term costs for diabetic foot care (9) and further increases risk for amputation and deterioration of

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Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

Cited by 147 publications

References 26 publications

Association between Patient Interpretation of Diabetic Peripheral Neuropathy and Foot Self-Care Behaviors

Association between Patient Interpretation of Diabetic Peripheral Neuropathy and Foot Self-Care Behaviors

Smarter Sole Survival: Will Neuropathic Patients at High Risk for Ulceration Use a Smart Insole-Based Foot Protection System?

Risk Factors for Plantar Foot Ulcer Recurrence in Neuropathic Diabetic Patients

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