AI Article Synopsis
- Adherence to offloading treatment is critical for healing diabetes-related foot ulcers (DFUs), but measuring self-reported adherence has questionable accuracy.
- A study with 53 participants compared self-reported adherence using removable cast walkers to objective measurements from activity monitors, revealing a significant overestimation of adherence (90% self-reported vs. 35% objective).
- The findings indicated that self-reported adherence is only fairly valid and reliable, suggesting that clinicians and researchers should prioritize objective measures for assessing adherence in DFU treatment.
Article Abstract
Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the validity and reliability of self-reported adherence to using removable cast walker (RCW) offloading treatment among people with DFUs. Fifty-three participants with DFUs using RCWs were included. Each participant self-reported their percentage adherence to using their RCW of total daily steps. Participants also had adherence objectively measured using dual activity monitors. After one week, a subset of 19 participants again self-reported their percentage adherence to investigate test-retest reliability. Validity was tested using Pearson's r and Bland-Altman tests, and reliability using Cohen's kappa. Median (IQR) self-reported adherence was greater than objectively measured adherence (90% (60-100) vs. 35% (19-47), < 0.01). There was fair agreement (r = 0.46; < 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, < 0.01) for validity, and minimal agreement for test-retest reliability (K = 0.36; < 0.01). The validity and reliability of self-reported offloading adherence in people with DFU are fair at best. People with DFU significantly overestimate their offloading adherence. Clinicians and researchers should instead use objective adherence measures.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181495 | PMC |
| http://dx.doi.org/10.3390/s23094423 | DOI Listing |
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