Biologic agents used to treat rheumatoid arthritis and their relevance to podiatrists: a practice update

Journal of Foot and Ankle Research

2017

BackgroundUp to 50% of people with rheumatoid arthritis (RA) have foot symptoms at diagnosis, hence early foot health intervention is recommended and this should include patient education. This study identifies, for the first time, the foot health education (FHE) needs of people with RA.MethodsAn online survey of people with RA (n = 543) captured quantitative data in relation to the aims, methods of delivery, content, timing and accessibility of FHE.ResultsThe majority concurred about the aims of FHE. Verbal delivery and websites were the most common methods. Written and verbal FHE were perceived to be the most effective methods. The point of diagnosis was the preferred time to receive it. Lack of access to FHE included minimal focus on foot health during consultations by both health practitioners and patients with RA. Participant gender, age, disease duration and living situation had a statistically significant influence on the results.ConclusionFoot health education is rarely considered within the medical consultation. There is a lack of patient and/or health professional awareness of this need with a detrimental impact on foot health. Patients require health professionals to identify their foot education health needs. Tailored foot health education should begin at initial diagnosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-017-0193-6) contains supplementary material, which is available to authorized users.

Section: Introductionmentioning

confidence: 99%

A survey of people with foot problems related to rheumatoid arthritis and their educational needs

Graham

Stephenson

Journal of Foot and Ankle Research

2017

“…The structural and functional changes in the feet often affect gait and mobility (Turner et al, ; Woodburn et al, ; Turner et al, ), impacting negatively on the patient's quality of life (Otter et al, ; Wickman et al, ) and specifically restricting the choice of footwear (Goodacre and Candy, ; Williams et al, , ). For some people with RA, the structural changes are a factor in foot ulcer development (Firth et al, ), with the risk of infection, particularly if the patient's medical management includes the use of immunosuppressive drugs (Otter et al, ; Wilske, ).…”

Section: Introductionmentioning

confidence: 99%

Guidelines for the Management of the Foot Health Problems Associated with Rheumatoid Arthritis

Davies

Graham

et al. 2011

Musculoskeletal Care

“…Seventy-five percent (75%) of patients with RA report foot pain within four years of diagnosis, with the degree of disability progressing with the course of the disease [4]. Shi stated that virtually 100% of patients report foot problems within 10 years of disease onset [5].…”

Section: Introductionmentioning

confidence: 99%

‘Choosing shoes’: a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients

Silvester

Journal of Foot and Ankle Research

Dalbeth

et al. 2010

BackgroundFootwear has been accepted as a therapeutic intervention for the foot affected by rheumatoid arthritis (RA). Evidence relating to the objective assessment of footwear in patients with RA is limited. The aims of this study were to identify current footwear styles, footwear characteristics, and factors that influence footwear choice experienced by patients with RA.MethodsEighty patients with RA were recruited from rheumatology clinics during the summer months. Clinical characteristics, global function, and foot impairment and disability measures were recorded. Current footwear, footwear characteristics and the factors associated with choice of footwear were identified. Suitability of footwear was recorded using pre-determined criteria for assessing footwear type, based on a previous study of foot pain.ResultsThe patients had longstanding RA with moderate-to severe disability and impairment. The foot and ankle assessment demonstrated a low-arch profile with both forefoot and rearfoot structural deformities. Over 50% of shoes worn by patients were open-type footwear. More than 70% of patients' footwear was defined as being poor. Poor footwear characteristics such as heel rigidity and sole hardness were observed. Patients reported comfort (17%) and fit (14%) as important factors in choosing their own footwear. Only five percent (5%) of patients wore therapeutic footwear.ConclusionsThe majority of patients with RA wear footwear that has been previously described as poor. Future work needs to aim to define and justify the specific features of footwear that may be of benefit to foot health for people with RA.