Corbett 2003.
Methods | RCT | |
Participants | 40 people with type 2 diabetes mellitus randomised: intervention 20 vs control 20 Baseline risk for foot ulceration: 70% had loss of protective sensation 67% had impaired lower extremity circulation 50% had a foot deformity Foot risk assessment: no significant differences between groups Baseline outcome measures: no significant differences between groups Study setting: community‐based care, people with type 2 diabetes mellitus admitted to home care in the USA Inclusion criteria: physically and mentally able to participate, able to read and understand English, age 18 years or older, no lower‐extremity ulcer, no history of lower‐extremity amputation |
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Interventions | Intervention group:
10 to 20 minutes' individualised patient education including verbal and written instructions according to participants' risk factors and foot care knowledge, self‐efficacy and reported self‐care behaviour by research nurse. Content: foot care education topics: individual risk factors, washing and drying feet, toenail care, footwear, moisturising feet, reportable foot problems. If desired: demonstration of nail trimming and problem‐solving discussion to discover alternative care solutions Control group: No intervention Adherence: 19 of 20 intervention group people attended the single education session |
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Outcomes | Primary outcomes: not reported Secondary outcomes: foot care knowledge score, foot care practice score, patients' self confidence scores | |
Duration and completion of follow‐up | 6 weeks after the intervention (people were enrolled in the study already 6 weeks prior to the intervention to ensure proper baseline measurements); 35 people completed follow‐up intervention 19 vs control 16 | |
Types of assessment | Foot care knowledge assessment: 7 questions with 4 choices; foot care practice assessment: 7 questions with 4 choices; patients' self confidence assessment: 7 aspects of foot care rated on a 6‐point scale | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Randomly drawing labelled consent forms, the sequence having been generated by shuffling |
Allocation concealment (selection bias) | Low risk | Consent form labels were covered by opaque stickers and randomly shuffled |
Blinding (performance bias and detection bias) Blinding of outcome assessors | Unclear risk | No information provided |
Incomplete outcome data (attrition bias) All outcomes | High risk | 35 of 40 people completed follow‐up (intervention 19 vs control 16). Reasons for missing data were not reported No ITT analyses were undertaken |
Selective reporting (reporting bias) | Low risk | No study protocol available, but the trial report lists the outcomes of interest in both the methods and the results section |
Other bias | Unclear risk | Baseline foot risk assessment: 'no significant differences between groups' Co‐interventions were not described Adherence: 19 of 20 intervention group people attended the single education session |