{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:37:29Z","timestamp":1793061449512,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Research Medical Council (NMRC) Research Training Fellowship Award","award":["FLWSHP19nov-0015"],"award-info":[{"award-number":["FLWSHP19nov-0015"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Effective treatment of diabetic foot ulcers (DFUs) involves a multidisciplinary treatment plan to promote wound healing and prevent complications. Given the lack of consensus data on the factors affecting patient adherence, a systematic review was performed to identify and classify factors according to the WHO Dimensions of Adherence to Long-Term Therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six hundred and forty-three articles from PubMed, Embase, and Scopus were reviewed. The inclusion criteria included qualitative and quantitative studies which discussed factors affecting patient adherence to DFU treatment, had study populations that comprised patients with either prior history of or existing DFU, and had either prior history of DFU treatment or were currently receiving treatment. Factors, and associated measures of adherence, were extracted and organized according to the WHO Dimensions of Adherence to Long-Term Therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven quantitative and eight qualitative studies were included. Eleven patient-related factors, seven condition-related factors, three therapy-related factors, five socioeconomic factors, and five health system-related factors were investigated by the included studies. The largest proportion of factors studied was patient-related, such as patient insight on DFU treatment, patient motivation, and patient perception of DFU treatment. There was notable overlap in the range of discussed factors across various domains, in the socioeconomic (including social support, income, social and cultural acceptability of DFU therapy, cost) and therapy-related domains (including duration of treatment, offloading footwear, and reminder devices). Different studies found that specific factors, such as gender and patients having a low internal locus of control, had differing effects on adherence on different cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current literature presents heterogeneous findings regarding factors affecting patient adherence. It would be useful for future studies to categorize factors as such to provide more comprehensive understanding and personalized care to patients. Further research can be done to explore how significant factors can be addressed universally across different cohort populations in different cultural and socioeconomic contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15347346241233962","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T18:13:43Z","timestamp":1708452823000},"page":"293-307","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9919-3859","authenticated-orcid":false,"given":"Gwyneth WY","family":"Ng","sequence":"first","affiliation":[{"name":"National University of Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith F","family":"Gan","sequence":"additional","affiliation":[{"name":"National University of Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiling","family":"Liew","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixia","family":"Ge","sequence":"additional","affiliation":[{"name":"National Healthcare Group Health Services and Outcomes Research Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Ang","sequence":"additional","affiliation":[{"name":"National Healthcare Group Health Services and Outcomes Research Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Molina","sequence":"additional","affiliation":[{"name":"National Healthcare Group Health Services and Outcomes Research Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"National Healthcare Group Health Services and Outcomes Research Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prajwala S","family":"Prakash","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keerthi B","family":"Harish","sequence":"additional","affiliation":[{"name":"NYU Langone Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwen Joseph","family":"Lo","sequence":"additional","affiliation":[{"name":"Woodlands Health"},{"name":"Lee Kong Chian School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12509"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12404"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12391"},{"key":"e_1_3_2_7_2","volume-title":"Adherence to long-term therapies: evidence for action","author":"World Health O","year":"2003","unstructured":"World Health Organization. Adherence to long-term therapies: evidence for action. World Health Organization; 2003."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2701"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-023-00614-2"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-2373"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"issue":"2","key":"e_1_3_2_12_2","first-page":"65","article-title":"Broadening horizons: integrating quantitative and qualitative research","volume":"8","author":"Verhoef MJ","year":"1997","unstructured":"Verhoef MJ, Casebeer AL. Broadening horizons: integrating quantitative and qualitative research. Can J Infect Dis. 1997;8(2):65-66. doi:https:\/\/doi.org\/10.1155\/1997\/349145","journal-title":"Can J Infect Dis"},{"key":"e_1_3_2_13_2","article-title":"The Cochrane collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins JP","unstructured":"Higgins JP, Altman DG, G\u00f8tzsche PC, et al. The Cochrane collaboration\u2019s tool for assessing risk of bias in randomised trials. Br Med J. 18 2011;343:d5928. doi:https:\/\/doi.org\/10.1136\/bmj.d5928","journal-title":"Br Med J"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-45"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1330"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13158"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296817747618"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816689105"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.7547\/16-171"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002640"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2002.02427.x"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0965-206X(03)80025-6"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2008.008011"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-019-0329-y"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/ANS.0000000000000328"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.08.127"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40200-021-00825-z"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-012-0004-9"},{"issue":"3","key":"e_1_3_2_29_2","article-title":"Personalised care planning for adults with chronic or long-term health conditions","volume":"2015","author":"Coulter A","year":"2015","unstructured":"Coulter A, Entwistle VA, Eccles A, Ryan S, Shepperd S, Perera R. Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database Syst Rev. 2015;2015(3):Cd010523. doi:https:\/\/doi.org\/10.1002\/14651858.CD010523.pub2","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.9.2549"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/16501970410033569"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080633"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-94"},{"issue":"3","key":"e_1_3_2_34_2","doi-asserted-by":"crossref","DOI":"10.1016\/j.jmir.2015.04.010","article-title":"A literature review of patient education: is IT time to move forward?","volume":"46","author":"McIntyre R","year":"2015","unstructured":"McIntyre R, Craig A. A literature review of patient education: is IT time to move forward? J Med Imaging Radiat Sci. 2015;46(3s):S75-s85. doi:https:\/\/doi.org\/10.1016\/j.jmir.2015.04.010","journal-title":"J Med Imaging Radiat Sci"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2001.tb00219.x"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-017-4199-3"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12361"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13052-9"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12046"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2015.03.004"},{"issue":"9","key":"e_1_3_2_41_2","article-title":"Burden of illness in type 2 diabetes mellitus","volume":"24","author":"Cannon A","year":"2018","unstructured":"Cannon A, Handelsman Y, Heile M, Shannon M. Burden of illness in type 2 diabetes mellitus. J Manag Care Spec Pharm. 2018;24(9-a Suppl):S5-S13. doi:https:\/\/doi.org\/10.18553\/jmcp.2018.24.9-a.s5","journal-title":"J Manag Care Spec Pharm"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.9627"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10059"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.3109\/02770903.2014.888572"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.3996"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.23.2.207"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-014-9663-2"},{"key":"e_1_3_2_48_2","first-page":"421","article-title":"Importance of family\/social support and impact on adherence to diabetic therapy","volume":"6","author":"Miller TA","unstructured":"Miller TA, Dimatteo MR. Importance of family\/social support and impact on adherence to diabetic therapy. Diabetes Metab Syndr Obes. 6 2013;6:421-426. doi:https:\/\/doi.org\/10.2147\/dmso.S36368","journal-title":"Diabetes Metab Syndr Obes"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.14.138149"},{"key":"e_1_3_2_50_2","first-page":"217","article-title":"Qualitative and quantitative research paradigms in business research: a philosophical reflection","volume":"7","author":"Antwi SK","year":"2015","unstructured":"Antwi SK, Hamza K. Qualitative and quantitative research paradigms in business research: a philosophical reflection. Europ J Business Manag. 2015;7:217-225.","journal-title":"Europ J Business Manag"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.00572"}],"container-title":["The International Journal of Lower Extremity Wounds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346241233962","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15347346241233962","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346241233962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:48:37Z","timestamp":1779400117000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15347346241233962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,20]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/15347346241233962"],"URL":"https:\/\/doi.org\/10.1177\/15347346241233962","relation":{},"ISSN":["1534-7346","1552-6941"],"issn-type":[{"value":"1534-7346","type":"print"},{"value":"1552-6941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,20]]}}}