Patients’ Buying Behavior for Non-Reimbursed Off-Loading Devices Used in Diabetic Foot Ulcer Treatment—An Observational Study during COVID-19 Pandemic from a Romanian Physical Therapy Unit

Author:

Dragoi Iulia Iovanca1,Popescu Florina Georgeta2ORCID,Bowling Frank L.13,Bondor Cosmina Ioana4ORCID,Ionac Mihai1

Affiliation:

1. Department of Vascular Surgery and Reconstructive Microsurgery, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania

2. Discipline of Occupational Health, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania

3. Department of Surgery & Translational Medicine, Faculty of Medical and Human Sciences, University of Manchester, Oxford Rd., Manchester M13 9PL, UK

4. Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy “Iuliu Hațieganu”, 8 Victor Babeș, 400000 Cluj-Napoca, Romania

Abstract

Diabetic foot ulcer non-reimbursed treatment depends on multiple factors, including the patient’s buying behaviors. Factors affecting buying behaviors for the removable off-loading devices are not completely understood. The aim of this study was to investigate the patients’ buying behaviors of the removable off-loading devices and their influence on the DFU treatment outcomes remotely monitored during the COVID-19 pandemic. In this prospective observational study, 45 patients affected by diabetic peripheral neuropathy, with/without peripheral arterial disease, with foot ulcers treated with removable devices were remotely monitored. Prefabricated removable cast walkers, insoles, and therapeutic footwear were the proposed off-loading methods. Patients affected by high blood pressure (p = 0.018), peripheral arterial disease (p = 0.029), past amputations (p = 0.018), and ulcer on the left foot (p = 0.007) bought removable cast walkers. Rural provenience (p = 0.011) and male (p = 0.034) did not buy a removable walker. The healing rate was 69.4%, while the median healing time was 20 weeks. High blood pressure negatively influenced healing time (p = 0.020). Patients who bought the most efficient treatment method for DFUs were females from urban provenience, with amputation in the past, with peripheral arterial disease, and with high blood pressure.

Publisher

MDPI AG

Subject

General Medicine

Reference122 articles.

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3. (2023, July 07). International Diabetes Federation (2009) Diabetes Atlas. 4th Edition. Available online: http://www.idf.org/sites/default/files/da5/IDF%20Diabetes%20Atlas%204th%20edition.pdf.

4. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes;Hicks;Curr. Diab. Rep.,2019

5. Shiferaw, W.S., Akalu, T.Y., Work, Y., and Aynalem, Y.A. (2020). Prevalence of diabetic peripheral neuropathy in Africa: A systematic review and meta-analysis. BMC Endocr. Disord., 20.

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