Adherence to Wearing Therapeutic Footwear Among People at High-Risk of Diabetes-Related Foot Ulcers in Jordan

Abstract

This study aimed to investigate the levels of adherence to wearing therapeutic footwear, and the factors associated, among people at high-risk of diabetes-related foot ulcers (DFUs) in Jordan. This was a secondary analysis of data from a multi-centre cross-sectional study of participants at high-risk of DFU in Jordan who had therapeutic footwear. Participants had socio-demographic, health, limb, and psychosocial variables collected, plus self-reported their proportion of adherence time wearing therapeutic footwear on an average day (excluding sleeping time) using a visual analogue scale. Participants were categorized into high (≥60%) or low (<60%) adherence levels, plus users (1%-100% adherence) or non-users (0% adherence) of therapeutic footwear. Of 104 included participants (mean age 58 ± 13 years, 68% males), 65 (62.5%) self-reported low adherence levels and 44 (42.3%) as non-users. No variables were independently associated with low adherence levels (P > .05). Whereas participants with lower self-reported foot care outcome expectation scores were independently associated with non-use of therapeutic footwear (P = .05). Most people at high-risk of DFUs in Jordan self-reported low adherence or total non-use of their therapeutic footwear. Perceived low footcare outcome expectations was the only factor found associated with non-use of therapeutic footwear and further research is needed to explore other potential factors.