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Med."],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to perform an up\u2010to\u2010date systematic review and meta\u2010analysis of randomized controlled trials (RCTs) examining the efficacy of home foot temperature monitoring, patient education and offloading footwear in reducing the incidence of diabetes\u2010related foot ulcers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature search was performed using MEDLINE, PubMed, CINAHL, Scopus and Cochrane databases to identify relevant original studies. Meta\u2010analyses were performed using intention\u2010to\u2010treat principals for worst (main analysis) and best (sub\u2010analysis) case scenarios. Leave\u2010one\u2010out sensitivity analyses were used to assess the consistency of findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 7575 unique records, 17 RCTs involving 2729 participants were included. Four tested home foot temperature monitoring (<jats:italic>n<\/jats:italic>\u00a0=\u00a0468), six examined patient education (<jats:italic>n<\/jats:italic>\u00a0=\u00a0823) and seven assessed offloading footwear (<jats:italic>n<\/jats:italic>\u00a0=\u00a01438). Participants\u2019 who performed home foot temperature monitoring [odds ratio (OR) 0.51, 95% confidence interval (CI) 0.31 to 0.84;<jats:italic>n<\/jats:italic>\u00a0=\u00a0468] and those provided offloading footwear (OR 0.48, 95% CI 0.29 to 0.80;<jats:italic>n<\/jats:italic>\u00a0=\u00a01438) were less likely to develop a diabetes\u2010related foot ulcer. Patient education programmes did not significantly reduce diabetes\u2010related foot ulcer incidence (OR 0.59, 95% CI 0.29 to 1.20;<jats:italic>n<\/jats:italic>\u00a0=\u00a0823). Sensitivity analyses suggested that offloading footwear findings were consistent, but home foot temperature findings were dependent on the individual inclusion of one trial. All RCTs had either high or unclear risk of bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis suggests that offloading footwear is effective in reducing the incidence of diabetes\u2010related foot ulcers. Home foot temperature monitoring also appears beneficial but larger trials are needed (PROSPERO registration no.: CRD42019135226).<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14323","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T11:23:06Z","timestamp":1589887386000},"page":"1266-1279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Meta\u2010analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes\u2010related foot ulcers"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9678-6420","authenticated-orcid":false,"given":"C.","family":"Alahakoon","sequence":"first","affiliation":[{"name":"Ulcer and Wound Healing Consortium (UHEAL) Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry Townsville Australia"},{"name":"Faculty of Medicine University of Peradeniya Peradeniya Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Fernando","sequence":"additional","affiliation":[{"name":"Ulcer and Wound Healing Consortium (UHEAL) Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry Townsville Australia"},{"name":"Australian Institute of Tropical Health and Medicine James Cook University Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Galappaththy","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Peradeniya Peradeniya Sri Lanka"},{"name":"Department of Vascular and Endovascular Surgery Townsville Hospital Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. O.","family":"Matthews","sequence":"additional","affiliation":[{"name":"Ulcer and Wound Healing Consortium (UHEAL) Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-7964","authenticated-orcid":false,"given":"P.","family":"Lazzarini","sequence":"additional","affiliation":[{"name":"School of Public Health and Social Work Queensland University of Technology Brisbane Australia"},{"name":"Allied Health Research Collaborative Metro North Hospital and Health Service Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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