Non-compliance with the use of SmartMats for remote foot temperature monitoring among Veterans in the Veterans Health Affairs: findings from an observational study (Preprint)-Reference-Cited by-同舟云学术

Non-compliance with the use of SmartMats for remote foot temperature monitoring among Veterans in the Veterans Health Affairs: findings from an observational study (Preprint)

Published:2023-09-25 Issue: Volume: Page:
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Author:

Littman Alyson J^ORCID,Timmons Andrew K^ORCID,Korpak Anna^ORCID,Chan Kwun CG^ORCID,Jones Kenneth T^ORCID,Shirley Suzanne^ORCID,Nordrum Kyle^ORCID,Robbins Jeffrey,Masadeh Suhail^ORCID,Moy Ernest

Abstract

BACKGROUND

In home remote foot temperature (RTM) monitoring holds promise as a method to reduce foot ulceration in high-risk patients with diabetes. Few studies have evaluated adherence to this method, or evaluated factors associated with non-compliance.

OBJECTIVE

The aims of this study were to estimate non-compliance in patients who were enrolled in RTM nationally across Department of Veterans Affairs (VA) and to evaluate characteristics associated with non-compliance.

METHODS

We conducted an observational study including 1137 patients in the VA who were enrolled in RTM between January 2019 and June 2021, with follow-up through October 2021. Patient information was obtained from the VA’s electronic health record and RTM use was obtained from the company. Non-compliance was defined as using the mat < 2 days per week for more than 25% (e.g., 3 of 12 months) of follow-up months. Using a multivariable model, we calculated odds ratios and 95% confidence intervals for associations between various factors and non-compliance.

RESULTS

The sample was predominantly male (99%) and white (76%); 20% were Black/African American. Overall, 38% of patients were classified as non-compliant. In the multivariable model, only higher area deprivation index (ADI) was statistically significantly and inversely associated with non-compliance (ADI 50-74 vs. 1-24: OR=0.56 ); factors significantly and positively associated with non-compliance included recent history of osteomyelitis (OR=1.44), Gagne comorbidity index score >4 (vs.<0: OR=1.81), telehealth encounters (28+ vs. <6: OR=1.70), hemoglobin A1c >10 (vs. <5.7: OR=2.67), and current smoking (OR=2.06).

CONCLUSIONS

To reduce the risk of ulcer recurrence and amputation, proactively providing additional support for self-monitoring to patients with characteristics identified in this study (poor glucose control, current smoking, high comorbidity burden) may be helpful. Furthermore, research is needed to better understand barriers to use, and whether the addition of design features may increase facilitators to use.

Publisher

JMIR Publications Inc.

Reference22 articles.

1. Home Monitoring of Foot Skin Temperatures to Prevent Ulceration

2. Preventing Diabetic Foot Ulcer Recurrence in High-Risk Patients

3. Skin Temperature Monitoring Reduces the Risk for Diabetic Foot Ulceration in High-risk Patients

4. A pilot study testing the feasibility of skin temperature monitoring to reduce recurrent foot ulcers in patients with diabetes – a randomized controlled trial

5. Effectiveness of at-home skin temperature monitoring in reducing the incidence of foot ulcer recurrence in people with diabetes: a multicenter randomized controlled trial (DIATEMP)