Orthotic Treatment of Diabetic Foot Ulcers: Patient Adherence to Prescribed Wear and Effectiveness of Treatment

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Patients who present to Podiatry with a diabetic foot ulcer are prescribed orthoses to offload and protect the foot from further damage. However, the available anecdotal and scholarly data suggests that patients do not wear orthoses as prescribed. There are often negative health consequences when these orthoses are not worn and added costs to the healthcare system associated with the negative health outcomes. The goal of this work is to encourage the use of orthoses by diabetic foot ulcer patients. The diabetic foot ulcer patient’s participating in this study will have their orthosis wear-time measured between clinic visits. The use of the orthosis will be encouraged in one group using education and motivational interviewing. Measured wear time will also be discussed with this group of patients. The second group of patients will not be actively encouraged to wear the orthosis. Routine clinical data will be collected in tandem with wear-time data in both groups. These data will be used to objectively determine how often patients wear their orthosis, whether active intervention can modulate orthosis wear time, and provide an objective measure of the effectiveness of orthosis use. The goal of the study is to improve outcomes for Veterans treated in the VA for diabetic foot ulcers, reduce complication rates from non-use of orthoses and to, thereby, reduce healthcare costs.