130. The Survey of Rheumatology Occupational Therapy Compression Glove Practice and Provision in the UK

Abstract

Background: Compression gloves are provided by rheumatology occupational therapists (OT) in routine clinical care to people with early or established rheumatoid arthritis (RA). They are prescribed for day and / or night wear, to reduce hand pain, stiffness and improve function. However, we know little about the size, extent and mechanisms of rheumatology OT compression glove provision in the NHS. Method: An online survey of the College of Occupational Therapists Specialist Section for Rheumatology (COTSSR) members’ compression glove practice and provision in the UK was conducted (n=82). Paper questionnaires were posted to those who could not access the online questionnaire. No personally identifiable data were collected. The data collected were primarily quantitative although participants were encouraged to provide additional comments. Results: 60 Rheumatology OTs (73%) completed the survey (band 5: 2; band 6: 30; band7: 23; band 8 and over: 5). Most responders provided compression gloves to patients with early and established RA (n=52 and n=49). One in three Rheumatology OTs stated compression glove provision was based on patients’ clinical needs (e.g. presence of symptoms such as: hand pain, joint swelling, early morning stiffness) rather than their diagnosis. The commonest brand issued was Isotoner, and 90% of gloves were ¾- and 10% full-finger length. Most (75%) provided compression gloves to early RA patients prior to the use of DMARDs, and 61% provided gloves to patients stable on DMARDs but with continuing hand symptoms. On average, rheumatology OTs issued 10 (SD 8.5) gloves/ month to patients with RA (early and established combined). Nearly three quarters (73%) provided replacement gloves without charge when the first gloves issued wore out. One in four OTs did not issue replacement gloves, instead providing patients with glove manufacturers’ contact details so patients could purchase replacement gloves themselves. Conclusions: Compression gloves are commonly provided to people with early and established RA by Rheumatology OTs in the NHS, including patients’ prior to and on stable regimens of DMARDs. Although this survey provided useful insight about compression glove practice and provision by rheumatology OTs in the UK, the sample was drawn from the COTSSR members, and may not be representative of wider rheumatology compression glove practice in the NHS.