Aim: Therapeutic shoes can prevent diabetic foot ulcers but adherence to using them often is low. Studies are needed to identify nonadherent patient groups and factors affecting adherence, laying the groundwork for future interventions to improve adherence (1,2). The aim was to investigate predictors of adherence to using therapeutic shoes.
Methods: A questionnaire was posted to 1245 people with therapeutic shoes because of diabetic foot complications. Variables that significantly correlated with adherence (Spearman’s correlation coefficient p<0.10) were entered into a stepwise linear multiple regression analysis where p-values <0.05 were considered statistically significant.*
Results: 443 (35.6%) questionnaires were analyzed (66.4% men, mean age 69.2 years). On average, people used their therapeutic shoes 50.3% of daytime (SD 32.8%). Adherence was higher among people who did paid work, made consistent choices about what shoe type to wear, kept their therapeutic shoes visible in their home, and had put their conventional shoes away (Table 1).
Conclusions: People not doing paid work may need extra support to improve adherence. The results provide insights in the mechanisms of adherence, where the establishment of new shoe wearing habits, daily cues to use therapeutic shoes, and daily temptations to wear conventional shoes seem important for adherence. Future studies should explore this further and develop interventions to improve adherence, focusing on these factors.