Predictive Variables for Patient Compliance with Physician Prescribed Orthotics

Abstract

Category: Other; Midfoot/Forefoot Introduction/Purpose: Custom and off-the-shelf orthotics frequently are prescribed by foot and ankle orthpaedic surgeons. This study aimed to quantify the rate at which patients receive their prescribed orthotic and explore the variables that could be predictive of patients’ receiving and using orthotics. Methods: We analyzed the demographics of 382 patients who received an orthotic prescription from a group of foot and ankle surgeons to assess variables predictive of patients receiving their prescribed orthotic. Of these 382 patients, 186 (49%) completed a survey regarding insurance status, cost of the orthotic, education, income, and satisfaction with the orthotic. This information was used to identify variables that may help identify patients who are at an increased risk of failing to receive their prescribed orthotic. Results: Patients received their orthotic at an overall rate of 61.2% (235/382). Patients with commercial insurance were more likely to receive their orthotic (67%) than patients with Medicaid (40%). Of the 186 patients who completed the survey, those whose insurance covered all or part of their orthotic were more likely to receive their orthotic (100% and 96%, respectively) compared to those whose insurance did not cover the orthotic (81.5%). Overall 86.5% reported being ‘better’ or ‘completely relieved’ with orthotic use, and 13.4% reported ‘no difference’ or ‘worse.’ There were no differences in receive rates according to age or gender, but there was a disparity in race, with 71% (155/219) of white and only 48% (72/151) of black patients receiving their orthotics. Conclusion: A substantial number of patients (38.8%) do not receive their physician-prescribed orthotic. Patients who do receive and use their orthotic report positive results. Insurance status, race, and coverage of costs by the insurance company play important roles in predicting which patients are at risk for failing to receive their orthotic.