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Evaluation of the effectiveness of remote foot temperature monitoring for prevention of amputation in a large integrated healthcare system

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posted on 2023-06-15, 16:31 authored by Alyson J Littman, Andrew K Timmons, Anna Korpak, KC Gary Chan, Kenneth T Jones, Suzanne Shirley, Kyle Nordrum, Jeffrey Robbins, Suhail Masadeh, Ernest Moy

  

Introduction: We evaluated the effectiveness of remote foot temperature monitoring (RTM) in the Veterans Affairs healthcare system. 

Research Design and Methods: We conducted a retrospective cohort study that included 924 eligible patients enrolled in RTM between 2019 and 2021 who were matched up to 3:1 to 2757 non-enrolled comparison patients. We used conditional Cox regression to estimate adjusted cause-specific hazard ratios (HR) and corresponding 95% confidence intervals (CI) for lower extremity amputation (LEA, primary outcome) and all-cause hospitalization and death (secondary outcomes). 

Results: RTM was not associated with LEA incidence (adjusted HR= 0.92, 95% CI 0.62-1.37) or all-cause hospitalization (aHR = 0.97, 95% CI 0.82-1.14), but was inversely associated (reduced risk) with death (aHR=0.63, 95% CI 0.49-0.82). 

Conclusions: This study does not provide support that RTM reduces the risk of LEA or all-cause hospitalization in individuals with a history of diabetic foot ulcer. Randomized controlled trials can overcome important limitations.

Funding

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. This work was supported in part by the Department of Veterans Affairs (VA) Health Services Research and Development and the VA Office of Health Equity (CIN 13-402).

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