MEDICAL OPINIONS, BELIEFS AND PRESCRIPTION OF ORTHOPEDIC FOOTWEAR - ASURVEY OF DUTCH ORTHOPEDISTS AND REHABILITATION PRACTITIONERS

Objectives: To get insight into medical opinions about the use of orth opaedic footwear and the medical and social factors related to the pre scription of orthopaedic footwear by orthopaedists and rehabilitation practitioners. Methods: In this study 85 orthopaedists and 96 rehabili tation practitioners filled out a questionnaire measuring perceived de sirability of prescribing orthopaedic footwear in specific medical con ditions, the perceived advantages of orthopaedic footwear, the perceiv ed disadvantages of orthopaedic footwear, the attitude to orthopaedic footwear and satisfaction with the co-operation with the pedorthist. C linicians were asked to estimate their referral rate of orthopaedic fo otwear. Results: Orthopaedists and rehabilitation practitioners agree that the prescription of orthopaedic footwear should be considered in the case of rheumatoid arthritis, amputation of the foot and diabetic foot and not be considered in the case of sprain and back pain. In the case of hallux valgi, dermatological problems and clavus (severe corn ) a reticent prescription policy seems to be the optimal choice. In th e other medical conditions studied no unequivocal prescription policy could be derived. Respondents who prescribed orthopaedic footwear more than the median (more than 50 prescriptions per year) were more often rehabilitation practitioner, perceived more advantages of prescriptio n footwear, perceived less disadvantages of prescription footwear and were more satisfied about the co-operation with the pedorthist. Conclu sion: In some medical conditions orthopaedists and rehabilitation prac titioners agree about the optimal use of orthopaedic footwear. In some other medical conditions orthopaedists and rehabilitation practitione rs are divided about the use of orthopaedic footwear. Reported rate of prescription was not related to desirability of prescription, but was related to beliefs such as perceived advantages, perceived disadvanta ges and satisfaction with co-operation with the pedorthist, underlinin g the importance of cognitive factors in prescription style.