Offloading treatment in people with diabetic foot disease: A systematic scoping review on adherence to foot offloading
Simona Racaru, Layla Bolton Saghdaoui, Jaya Roy Choudhury, Mary Wells, Alun H. Davies
Abstract
BACKGROUND AND AIMS: To identify measurement methods, proportions of adherent participants, factors affecting adherence, and concordance promoting interventions. METHODS: A systematic scoping review was conducted by searching Medline, CINAHL, PubMed, EMBASE, and EMCARE databases. RESULTS: Twenty-four trials were identified from 1001 citations. Only 25% of the included studies used objective methods to quantify adherence. The proportion of adherent participants (≥80% of daily steps/time) ranged from 28% to 60%. Psychosocial factors are the most common influencers of adherence. However, interventions for improving compliance are lacking. CONCLUSION: There is a need to accurately quantify and optimize adherence to foot offloading in people with diabetes.