HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wooldridge, J Articles by Thornton, C Search for Related Content PubMed PubMed Citation Articles by Wooldridge, J Articles by Thornton, C

Preventing diabetic foot disease: lessons from the Medicare therapeutic shoe demonstration.

J Wooldridge, J Bergeron and C Thornton

Mathematica Policy Research Inc, Princeton, NJ, USA.

OBJECTIVES. Every year about 38,000 elderly people with diabetes have a lower extremity amputation. Therapeutic shoes are prescribed by clinicians specializing in foot care to prevent foot ulcerations and amputations among at-risk patients with diabetes. Medicare ran a 3-year demonstration of a therapeutic-shoe benefit for beneficiaries with diabetes. Medicare added the benefit nationwide in May 1993. METHODS. This paper describes the benefit and its implementation in the demonstration based on demonstration records, a patient survey, and discussions with clinicians and shoe suppliers before and during the demonstration. RESULTS. During the demonstration, far fewer beneficiaries applied for the therapeutic shoes than were eligible for them. The paper discusses reasons for the low beneficiary application rate and the associated low participation rate among physicians treating patients with diabetes. CONCLUSIONS. The benefit is unlikely to be used any more in the national program than in the demonstration unless physicians are educated in the role therapeutic shoes can play in diabetic foot disease, they prescribe the shoes for their patients, and they increase their patients' awareness of the shoes' value.

This article has been cited by other articles:

				S. A. Boren, T. L. Gunlock, J. Schaefer, and A. Albright Reducing Risks in Diabetes Self-management: A Systematic Review of the Literature The Diabetes Educator, November 1, 2007; 33(6): 1053 - 1077. [Abstract] [Full Text] [PDF]

				C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2007; 30(suppl_1): S96 - S103. [Full Text] [PDF]

				C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2006; 29(suppl_1): S78 - S85. [Full Text] [PDF]

				C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2005; 28(suppl_1): S72 - S79. [Full Text] [PDF]

				C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2004; 27(90001): s143 - 143. [Full Text] [PDF]

				D. J. Macfarlane and J. L. Jensen Factors in Diabetic Footwear Compliance J Am Podiatr Med Assoc, November 1, 2003; 93(6): 485 - 491. [Abstract] [Full Text] [PDF]

				C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2003; 26(90001): s149 - 156. [Full Text] [PDF]

				G. E. Reiber, D. G. Smith, C. Wallace, K. Sullivan, S. Hayes, C. Vath, M. L. Maciejewski, O. Yu, P. J. Heagerty, and J. LeMaster Effect of Therapeutic Footwear on Foot Reulceration in Patients With Diabetes: A Randomized Controlled Trial JAMA, May 15, 2002; 287(19): 2552 - 2558. [Abstract] [Full Text] [PDF]

				D. G. Armstrong, P. L. Abu-Rumman, B. P. Nixon, and A. J.M. Boulton Continuous Activity Monitoring in Persons at High Risk for Diabetes-Related Lower-Extremity Amputation J Am Podiatr Med Assoc, October 1, 2001; 91(9): 451 - 455. [Abstract] [Full Text] [PDF]

				R. Dahmen, R. Haspels, B. Koomen, and A. F. Hoeksma Therapeutic Footwear for the Neuropathic Foot: An algorithm Diabetes Care, April 1, 2001; 24(4): 705 - 709. [Abstract] [Full Text]

				C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, O. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education The Diabetes Educator, July 1, 2000; 26(4): 611 - 626. [PDF]