Clinical guidance for podiatrists in the management of foot problems in rheumatic disorders: evaluation of an educational programme for podiatrists using a mixed methods design

Abstract

Background Foot and ankle problems are common in rheumatic disorders and often lead to pain and limitations in functioning, affecting quality of life. There appears to be large variability in the management of foot problems in rheumatic disorders across podiatrists. To increase uniformity and quality of podiatry care for rheumatoid arthritis (RA), osteoarthritis (OA), spondyloarthritis (SpA), and gout a clinical protocol has been developed. Research objectives [1] to evaluate an educational programme to train podiatrists in the use of the protocol and [2] to explore barriers and facilitators for the use of the protocol in daily practice. Method This study used a mixed method design and included 32 podiatrists in the Netherlands. An educational programme was developed and provided to train the podiatrists in the use of the protocol. They thereafter received a digital questionnaire to evaluate the educational programme. Subsequently, podiatrists used the protocol for three months in their practice. Facilitators and barriers that they experienced in the use of the protocol were determined by a questionnaire. Semi-structured interviews were held to get more in-depth understanding. Results The mean satisfaction with the educational programme was 7.6 (SD 1.11), on a 11 point scale. Practical knowledge on joint palpation, programme variation and the use of practice cases were valued most. The protocol appeared to provide support in the diagnosis, treatment and evaluation of foot problems in rheumatic disorders and the treatment recommendations were clear and understandable. The main barrier for use of the protocol was time. The protocol has not yet been implemented in the electronic patient file, which makes it more time consuming. Other experienced barriers were the reimbursement for the treatment and financial compensation. Conclusions The educational programme concerning the clinical protocol for foot problems in rheumatic disorders appears to be helpful for podiatrists. Podiatrists perceived the protocol as being supportive during patient management. Barriers for use of the protocol were identified and should be addressed prior to large scale implementation. Whether the protocol is also beneficial for patients, needs to be determined in future research.

Health-Seeking Behaviors and Misconceptions about Osteoarthritis in Patients and the General Population in Saudi Arabia

“…We were not able to find the registered number of podiatrists working in Saudi Arabia. A research study from the Netherlands found that podiatrists perceived that there was an improvement in patient management after they had participated in an educational training program [37].…”

An evaluation of podiatry service use for people with inflammatory rheumatic diseases: a review of a rheumatology podiatry clinic in Aotearoa New Zealand

“…Results from this study have also demonstrated the range of foot-care interventions provided to people with inflammatory rheumatic diseases. Consistent with current guidelines and expert recommendations [14,[24][25][26][27][28], patients attending the AUT Podiatric Rheumatology Clinic received treatment of skin and nail problems, wound care, clinical padding, foot orthoses, and footwear prescription and advice. However, the most common intervention was foot-care education, provided during almost all appointments.…”

“…Finally, in reference to wait times, the relatively short wait times between referral and appointment observed in the current review are promising (median ~2 months). The majority of patients also attended regular four-monthly appointments which may support the importance of regular foot-care to prevent the development of new foot problems and address the changing concerns of the patient over time [14,[24][25][26][27][28].…”

Correction to: Clinical guidance for podiatrists in the management of foot problems in rheumatic disorders: evaluation of an educational programme for podiatrists using a mixed methods design

“…Following publication of the original article [1], we were notified that Fig. 2 should be the figure of the supplementary material (Additional file 2).…”