I04 Foot Health Education for People with Rheumatoid Arthritis: A Survey of Patients’ Perceived Needs and Experiences

Abstract

Objective Up to 90% of people with rheumatoid arthritis experience foot problems leading to reduced function, mobility, quality of life and social participation and impacts on body image, but can be improved with; general foot care, orthoses, footwear and patient education. Foot health patient education is lacking, hence the aim of this study was to identify the foot health educational needs of people with RA in relation to its content, timing, mode of delivery and the perceived barriers to its provision. Methods People with RA completed an online survey and provided free text comments for thematic analysis. Results 543 people with RA completed the survey (F=487, M=56). The majority of participants were aged between 40 and 69 years of age (85.5%, n= 464) and had disease duration of more than 5 years (67.3%, n= 365). 183 stated they had received foot health education. The majority agreed with the stated aims of foot health education. Verbal delivery and the use of websites were the most common methods. Written and verbal were perceived to be the most effective methods of delivery and overall, the point of diagnosis was the preferred time to receive it. Barriers to accessing foot health education included a lack of perceived opportunities to ask about foot health during consultations and a lack of clarity about what they should ask health practitioners in relation to their foot health and RA. 249/543 people completed the survey free text section. Five main themes emerged from qualitative analysis: “Forgotten Feet”, “Too little, too late”, “Lacks and Gaps”, “I am my feet” and “Game of Chance”. Conclusion This is the first study to provide insight to the current status of FHE for people with RA in the UK. ‘Patchy’ geographical provision of foot health services to people with RA remains similar to that of 10 years ago. People with RA lack awareness of; foot health issues, safe self-management and of service provision, driving them to seek out information for themselves. Foot pathology in people with RA has a profound bio-psychosocial impact on their lives, despite this foot health and related information appears to be rarely considered within the medical consultation. People with RA want access to foot health information and services but this is limited due to a lack of patient and/or health professional awareness leading to a detrimental impact on the prognosis of their foot health. The importance of foot health in people with RA needs reinforcing for both patients and health professionals. Opportunities to discuss foot health within the medical consultation should be regularly provided.